Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Restorigin 1 sq cm
Houston, TX
See all hospitals reporting HCPCS Q4191 →Price type
Methodist West Houston Hospital’s median price of $204 is 45% below the median hospital's median price ($369), higher than 34% of the 917 hospitals reporting HCPCS Q4191. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 11 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield medicare managed care - hmo fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 2 | Aetna medicare managed care - hmo/ppo fee schedule · outpatient | $127 | $127 | — | — | — | $127 – $127 |
| 3 | UnitedHealthcare medicare managed care - hmo fee schedule · outpatient | $128 | $128 | — | — | — | $128 – $128 |
| 4 | Cigna texas healthspring medicare managed care - hmo/ppo fee schedule · outpatient | $129 | $129 | — | — | — | $129 – $129 |
| 5 | Molina advantage medicare managed care plan fee schedule · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 6 | Optum transplant medicare managed care plan fee schedule · outpatient | $244 | $244 | — | — | — | $244 – $244 |
| 7 | Molina exchange fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 8 | Cigna local plus/surefit hmo/ppo fee schedule · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 9 | Cigna network c-24 hmo/ppo fee schedule · outpatient | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 10 | Cigna pcp optional/pcp required benefit plans hmo fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 11 | UnitedHealthcare all commercial plans fee schedule · outpatient | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
Last updated: Apr 1, 2026
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