APLIGRAF, PER SQUARE CENTIMETER at Ukiah Adventist Hospital

Ukiah, CA

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Pricing by billing methodology

Price type

How this price compares nationally

Ukiah Adventist Hospital’s median price of $135 is 12% above the median hospital's median price ($120), higher than 64% of the 1,917 hospitals reporting HCPCS Q4101. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q4101 at Ukiah Adventist Hospital

Negotiated rates from the hospital’s own file: 7 payers, 24 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 aetna-all plans fee schedule · outpatient	$30	$30	—	—	—	$30 – $30
2	Cigna cigna-all plans fee schedule · outpatient	$30	$30	—	—	—	$30 – $30
3	Kaiser kaiser medi-cal fee schedule · outpatient	$37	$37	$7	19%	—	$30 – $44
4	Medicaid medi-cal fee schedule · outpatient	$37	$37	$7	19%	—	$30 – $44
5	Blue Cross Blue Shield blue shield epn-all other plans fee schedule · outpatient	$50	$50	—	—	—	$50 – $50
6	Blue Cross Blue Shield blue shield non-epn fee schedule · outpatient	$53	$53	—	—	—	$53 – $53
7	UnitedHealthcare uhc jll csp 1/1/25 fee schedule · outpatient	$57	$57	$26	46%	—	$30 – $83
8	Blue Cross Blue Shield blue shield epn-all other plans percent of total billed charges · outpatientfrom % of charges	$64	$64	—	—	—	$64 – $64
9	Blue Cross Blue Shield blue shield non-epn percent of total billed charges · outpatientfrom % of charges	$65	$65	—	—	—	$65 – $65
10	Kaiser kaiser-all other plans percent of total billed charges · outpatientfrom % of charges	$98	$98	$37	37%	—	$62 – $135
11	Aetna aetna-all plans percent of total billed charges · outpatientfrom % of charges	$112	$112	—	—	—	$112 – $112
12	Cigna cigna-all plans percent of total billed charges · outpatientfrom % of charges	$132	$132	—	—	—	$132 – $132
13	MultiPlan phcs multiplan-all plans percent of total billed charges · outpatientfrom % of charges	$135	$135	—	—	—	$135 – $135
14	Blue Cross Blue Shield blue shield mcr adv fee schedule · outpatient	$139	$139	—	—	—	$139 – $139
15	Blue Cross Blue Shield blue shield mcr adv other · outpatient	$139	$139	—	—	—	$139 – $139
16	Blue Cross Blue Shield tricare blue shield-all plans fee schedule · outpatient	$139	$139	—	—	—	$139 – $139
17	Blue Cross Blue Shield tricare blue shield-all plans other · outpatient	$139	$139	—	—	—	$139 – $139
18	Kaiser kaiser mcr adv fee schedule · outpatient	$139	$139	—	—	—	$139 – $139
19	Kaiser kaiser mcr adv other · outpatient	$139	$139	—	—	—	$139 – $139
20	UnitedHealthcare uhc mcr adv other · outpatient	$139	$139	—	—	—	$139 – $139
21	Blue Cross Blue Shield blue cross exchange fee schedule · outpatient	$171	$171	—	—	—	$171 – $171
22	UnitedHealthcare uhc all payer-all other plans fee schedule · outpatient	$188	$188	$158	84%	—	$30 – $346
23	Blue Cross Blue Shield blue cross non-mcs fee schedule · outpatient	$190	$190	—	—	—	$190 – $190
24	Blue Cross Blue Shield blue cross mcs-all other plans fee schedule · outpatient	$228	$228	—	—	—	$228 – $228

Last updated: May 24, 2026

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