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HANK Price Transparency. (n.d.).
Revitalon 1 square cm (OTHER Q4157) by State .
PPMan price-transparency data, derived from CMS-required hospital MRFs.
Retrieved June 28, 2026 , from http://ppman.hank.ai/transparency/procedure/Q4157/by-state?code_type=OTHER
“Revitalon 1 square cm (OTHER Q4157) by State.” HANK Price Transparency ,
http://ppman.hank.ai/transparency/procedure/Q4157/by-state?code_type=OTHER. Accessed
June 28, 2026 .
“Revitalon 1 square cm (OTHER Q4157) by State,” HANK Price Transparency ,
accessed June 28, 2026 ,
http://ppman.hank.ai/transparency/procedure/Q4157/by-state?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital
machine-readable files (45 CFR 180). See
methodology .
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OTHER · across United States
Q4157 — Revitalon 1 Square Cm
State-by-state median negotiated rates. Lower bars are cheaper states; the
range bar shows the IQR (25th to 75th percentile within each state).
$147
National median
$50 – $245
IQR (p25 – p75)
52
hospitals filing
18
states
Median negotiated rate, by state
Ranked by typical (median) negotiated price. Hover for state-level IQR.
Median negotiated rate by state for Q4157 (OTHER), with interquartile range
State Median p25 p75
NV $3,630 $2,518 $8,117
AL $750 $750 $750
NY $709 $214 $1,158
VA $436 $436 $436
MI $335 $335 $335
NC $240 $166 $256
TN $216 $207 $263
MN $209 $209 $209
MT $203 $203 $203
WV $196 $120 $201
AR $192 $192 $192
NH $191 $178 $333
PA $178 $178 $353
SC $158 $158 $158
UT $127 $126 $135
CO $50 $50 $214
IN $48 $48 $48
KY $48 $48 $48