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
Peoria, IL
See all hospitals reporting HCPCS Q4191 →Price type
Proctor Community Hospital’s median price of $133 is 64% below the median hospital's median price ($369), higher than 22% 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: 7 payers, 10 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 | Aetna medicare advantage case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 2 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 3 | Humana medicare advantage case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 4 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 5 | Molina medicare-medicaid (mmai/dual) case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 6 | UnitedHealthcare medicare advantage case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 7 | UnitedHealthcare va ccn case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 8 | WellCare medicare advantage hmo case rate · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 9 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 10 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
Last updated: Apr 15, 2026
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