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
ALLOGRAFT DECELLULARIZED DERMIS WITH MATRACELL
Arcadia, CA
See all hospitals reporting HCPCS Q4125 →Price type
USC Arcadia Hospital’s median price of $268 is 56% below the median hospital's median price ($603), higher than 36% of the 1,317 hospitals reporting HCPCS Q4125. 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, 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 | Blue Cross Blue Shield blue shield sr other facility · fee schedule · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 2 | Blue Cross Blue Shield blue shield sr mediconnect facility · fee schedule · outpatient | $154 | $154 | — | — | — | $154 – $154 |
| 3 | Blue Cross Blue Shield blue shield sr facility · fee schedule · outpatient | $159 | $159 | — | — | — | $159 – $159 |
| 4 | Molina molina exchange (mcr) facility · fee schedule · outpatient | $167 | $167 | — | — | — | $167 – $167 |
| 5 | Cigna cigna facility · other · outpatient | $182 | $182 | — | — | — | $182 – $182 |
| 6 | Cigna cigna ppo facility · other · outpatient | $182 | $182 | — | — | — | $182 – $182 |
| 7 | Blue Cross Blue Shield blue cross facility · fee schedule · outpatient | $620 | $620 | — | — | — | $620 – $620 |
| 8 | Blue Cross Blue Shield blue shield hmo facility · percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.8k | $1.7k | 96% | — | $114 – $4.0k |
| 9 | Blue Cross Blue Shield blue shield ppo facility · percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.8k | $1.7k | 96% | — | $114 – $4.0k |
| 10 | Blue Cross Blue Shield blue shield exchange facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.4k | $2.3k | 96% | — | $148 – $5.2k |
| 11 | Phcs phcs facility · percent of total billed charges · inpatientfrom % of charges | $2.5k | $2.9k | $2.8k | 96% | — | $184 – $6.5k |
| 12 | Phcs phcs facility · percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.9k | $2.8k | 96% | — | $184 – $6.5k |
| 13 | Blue Cross Blue Shield blue shield hmo facility · other · outpatient | $3.1k | $3.2k | $3.0k | 93% | — | $224 – $6.7k |
| 14 | Blue Cross Blue Shield blue shield ppo facility · other · outpatient | $3.1k | $3.3k | $3.1k | 94% | — | $224 – $6.9k |
| 15 | MultiPlan multiplan facility · percent of total billed charges · inpatientfrom % of charges | $3.7k | $4.3k | $4.1k | 96% | — | $268 – $9.5k |
| 16 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $3.7k | $4.3k | $4.1k | 96% | — | $268 – $9.5k |
| 17 | Cigna cigna facility · percent of total billed charges · inpatientfrom % of charges | $5.1k | $5.1k | $753 | 15% | — | $4.3k – $5.8k |
| 18 | Cigna cigna facility · percent of total billed charges · outpatientfrom % of charges | $5.1k | $5.1k | $753 | 15% | — | $4.3k – $5.8k |
| 19 | Cigna cigna ppo facility · percent of total billed charges · inpatientfrom % of charges | $5.1k | $5.1k | $753 | 15% | — | $4.3k – $5.8k |
| 20 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $5.1k | $5.1k | $753 | 15% | — | $4.3k – $5.8k |
| 21 | UnitedHealthcare uhc navigate/select facility · other · inpatient | $6.2k | $6.2k | — | — | — | $6.2k – $6.2k |
| 22 | UnitedHealthcare uhc navigate/select facility · other · outpatient | $6.2k | $6.2k | — | — | — | $6.2k – $6.2k |
| 23 | UnitedHealthcare uhc all payer facility · other · inpatient | $8.0k | $8.0k | — | — | — | $8.0k – $8.0k |
| 24 | UnitedHealthcare uhc all payer facility · other · outpatient | $8.0k | $8.0k | — | — | — | $8.0k – $8.0k |
Last updated: Jul 27, 2026
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