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
ALLOWRAP 2 X4 CM
Pasadena, TX
See all hospitals reporting HCPCS Q4150 →Price type
Pmc Hospital, Llc’s median price of $3.0k is 1641% above the median hospital's median price ($171), higher than 90% of the 1,235 hospitals reporting HCPCS Q4150. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 42 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 | UnitedHealthcare commercial|exchange fee schedule · outpatient | $124 | $124 | — | — | — | $124 – $124 |
| 2 | UnitedHealthcare commercial|charter fee schedule · outpatient | $186 | $186 | — | — | — | $186 – $186 |
| 3 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $186 | $186 | — | — | — | $186 – $186 |
| 4 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $186 | $186 | — | — | — | $186 – $186 |
| 5 | Cigna commercial|ppo fee schedule · outpatient | $253 | $253 | — | — | — | $253 – $253 |
| 6 | Cigna commercial|hmo fee schedule · outpatient | $267 | $267 | — | — | — | $267 – $267 |
| 7 | Cigna commercial|surefit fee schedule · outpatient | $267 | $267 | — | — | — | $267 – $267 |
| 8 | Blue Cross Blue Shield commercial|exchange fee schedule · outpatient | $2.2k | $2.7k | $2.1k | 80% | — | $168 – $6.1k |
| 9 | Blue Cross Blue Shield commercial|blue premier fee schedule · outpatient | $2.3k | $2.8k | $2.2k | 80% | — | $176 – $6.4k |
| 10 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $2.3k | $2.8k | $2.2k | 80% | — | $176 – $6.4k |
| 11 | Blue Cross Blue Shield commercial|blue premier fee schedule · inpatient | $2.6k | $3.2k | $2.6k | 80% | — | $200 – $7.2k |
| 12 | Blue Cross Blue Shield commercial|myblue health exchange fee schedule · outpatient | $2.7k | $3.3k | $2.7k | 80% | — | $207 – $7.5k |
| 13 | UnitedHealthcare commercial|exchange fee schedule · inpatient | $2.7k | $3.3k | $2.7k | 80% | — | $207 – $7.5k |
| 14 | Aetna commercial|hmo fee schedule · inpatient | $2.8k | $3.4k | $2.8k | 81% | — | $200 – $8.4k |
| 15 | Aetna commercial|hmo fee schedule · outpatient | $2.8k | $3.4k | $2.8k | 81% | — | $200 – $8.4k |
| 16 | Blue Cross Blue Shield commercial|hmo fee schedule · outpatient | $2.8k | $3.4k | $2.8k | 80% | — | $215 – $7.8k |
| 17 | Blue Cross Blue Shield commercial|myblue health exchange fee schedule · inpatient | $2.9k | $3.6k | $2.9k | 80% | — | $223 – $8.1k |
| 18 | Aetna commercial|ppo fee schedule · inpatient | $3.0k | $3.7k | $3.0k | 80% | — | $231 – $8.4k |
| 19 | Aetna commercial|ppo fee schedule · outpatient | $3.0k | $3.7k | $3.0k | 80% | — | $231 – $8.4k |
| 20 | Blue Cross Blue Shield commercial|hmo fee schedule · inpatient | $3.0k | $3.7k | $3.0k | 80% | — | $231 – $8.4k |
| 21 | Blue Cross Blue Shield commercial|ppo fee schedule · outpatient | $3.1k | $3.8k | $3.1k | 80% | — | $239 – $8.7k |
| 22 | Cigna commercial|hmo fee schedule · inpatient | $3.1k | $3.8k | $3.1k | 80% | — | $239 – $8.7k |
| 23 | Cigna commercial|ppo fee schedule · inpatient | $3.1k | $3.8k | $3.1k | 80% | — | $239 – $8.7k |
| 24 | Cigna commercial|surefit fee schedule · inpatient | $3.1k | $3.8k | $3.1k | 80% | — | $239 – $8.7k |
| 25 | Blue Cross Blue Shield commercial|ppo fee schedule · inpatient | $3.2k | $3.9k | $3.2k | 80% | — | $247 – $9.0k |
Last updated: Feb 28, 2026
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