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
ALLOGRAFT PLACENTAL TISSUE EPIFIX 2 X 2CM SHEET ( IMPLANT QTY = 4CM ) -- # GS-5220
Utica, NY
See all hospitals reporting HCPCS Q4186 →Price type
MVHS, Inc.’s median price of $845 is 187% above the median hospital's median price ($295), higher than 80% of the 1,871 hospitals reporting HCPCS Q4186. 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, 9 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 | Excellus excellus bcbs medicaid percent of total billed charges · bothfrom % of charges | $340 | $335 | $83 | 25% | — | $186 – $443 |
| 2 | UnitedHealthcare uhc empire plan percent of total billed charges · bothfrom % of charges | $514 | $507 | $126 | 25% | — | $282 – $670 |
| 3 | Aetna aetna commercial percent of total billed charges · bothfrom % of charges | $766 | $755 | $187 | 25% | — | $420 – $999 |
| 4 | Bcbs Ny excellus bcbs indemnity percent of total billed charges · bothfrom % of charges | $875 | $863 | $214 | 25% | — | $480 – $1.1k |
| 5 | Blue Cross Blue Shield excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges | $875 | $863 | $214 | 25% | — | $480 – $1.1k |
| 6 | Excellus excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges | $875 | $863 | $214 | 25% | — | $480 – $1.1k |
| 7 | Excellus excellus bcbs indemnity percent of total billed charges · bothfrom % of charges | $875 | $863 | $214 | 25% | — | $480 – $1.1k |
| 8 | UnitedHealthcare uhc commercial percent of total billed charges · bothfrom % of charges | $938 | $925 | $230 | 25% | — | $515 – $1.2k |
| 9 | Humana humana hmo/pos percent of total billed charges · bothfrom % of charges | $964 | $950 | $236 | 25% | — | $529 – $1.3k |
Last updated: Aug 7, 2026
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