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
Derma-gide, 1 sq cm
Cedar Rapids, IA
See all hospitals reporting HCPCS Q4203 →Price type
St Luke's Methodist Hospital’s median price of $300 is 17% above the median hospital's median price ($256), higher than 57% of the 935 hospitals reporting HCPCS Q4203. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 3 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 | Cigna commercial fee schedule · both | $269 | $269 | — | — | — | $269 – $269 |
| 2 | UnitedHealthcare hmo fee schedule · both | $292 | $292 | — | — | — | $292 – $292 |
| 3 | UnitedHealthcare ppo fee schedule · both | $292 | $292 | — | — | — | $292 – $292 |
| 4 | Wellmark commercial fee schedule · both | $300 | $300 | — | — | — | $300 – $300 |
| 5 | Wellmark commercial fee schedule · outpatient | $300 | $300 | — | — | — | $300 – $300 |
| 6 | Wellmark hmo fee schedule · both | $300 | $300 | — | — | — | $300 – $300 |
| 7 | Wellmark hmo fee schedule · outpatient | $300 | $300 | — | — | — | $300 – $300 |
| 8 | Wellmark ppo fee schedule · both | $300 | $300 | — | — | — | $300 – $300 |
| 9 | Wellmark ppo fee schedule · outpatient | $300 | $300 | — | — | — | $300 – $300 |
Last updated: Jan 28, 2026
See Derma-Gide skin substitute, per square centimeter pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.