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
S-ARM SPLINT FIBERGLS >=11 YRS
Williamsport, PA
See all hospitals reporting HCPCS Q4022 →Price type
UPMC Williamsport’s median price of $126 is 698% above the median hospital's median price ($16), higher than 99% of the 836 hospitals reporting HCPCS Q4022. 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, 21 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 facility · percent of total billed charges · outpatientfrom % of charges | $51 | $51 | — | — | — | $51 – $51 |
| 2 | Highmark managed care - social mission facility · percent of total billed charges · outpatientfrom % of charges | $75 | $75 | — | — | — | $75 – $75 |
| 3 | Aetna pebtf custom network facility · percent of total billed charges · outpatientfrom % of charges | $76 | $76 | — | — | — | $76 – $76 |
| 4 | Aetna pebtf custom network facility · percent of total billed charges · inpatientfrom % of charges | $81 | $81 | — | — | — | $81 – $81 |
| 5 | Highmark bluecare hmo/fplic ppo/traditional products facility · percent of total billed charges · outpatientfrom % of charges | $88 | $88 | — | — | — | $88 – $88 |
| 6 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $90 | $90 | — | — | — | $90 – $90 |
| 7 | First Health commercial facility · percent of total billed charges · outpatientfrom % of charges | $94 | $94 | — | — | — | $94 – $94 |
| 8 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $95 | $95 | — | — | — | $95 – $95 |
| 9 | First Health commercial facility · percent of total billed charges · inpatientfrom % of charges | $99 | $99 | — | — | — | $99 – $99 |
| 10 | Aetna first health facility · percent of total billed charges · inpatientfrom % of charges | $124 | $124 | — | — | — | $124 – $124 |
| 11 | Aetna first health facility · percent of total billed charges · outpatientfrom % of charges | $124 | $124 | — | — | — | $124 – $124 |
| 12 | First Health fh-medical rental facility · percent of total billed charges · inpatientfrom % of charges | $127 | $127 | — | — | — | $127 – $127 |
| 13 | First Health fh-medical rental facility · percent of total billed charges · outpatientfrom % of charges | $127 | $127 | — | — | — | $127 – $127 |
| 14 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $129 | $129 | — | — | — | $129 – $129 |
| 15 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $129 | $129 | — | — | — | $129 – $129 |
| 16 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $129 | $129 | — | — | — | $129 – $129 |
| 17 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $129 | $129 | — | — | — | $129 – $129 |
| 18 | MultiPlan auto facility · percent of total billed charges · inpatientfrom % of charges | $147 | $147 | — | — | — | $147 – $147 |
| 19 | MultiPlan auto facility · percent of total billed charges · outpatientfrom % of charges | $147 | $147 | — | — | — | $147 – $147 |
| 20 | MultiPlan ppo (includes phcs as a payer) facility · percent of total billed charges · inpatientfrom % of charges | $147 | $147 | — | — | — | $147 – $147 |
| 21 | MultiPlan ppo (includes phcs as a payer) facility · percent of total billed charges · outpatientfrom % of charges | $147 | $147 | — | — | — | $147 – $147 |
Last updated: Mar 6, 2026
See Short arm splint, fiberglass (adult) pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.