Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet cost at US hospitals

ALLOGRAFT AMNIOTIC ACTIVEBARRIER 200 2X2CM-Q4100-COST PER SHEET · HCPCS Q4100

$424.70

lowest cash price

$9,900.02

national median

$68,375.58

highest cash price

330

hospitals with a published cash price

Middle half of hospitals (25th–75th percentile) against the full range. The same procedure varies $424.70–$68,375.58 — the variation is the story.

Cheapest published cash price

$424.70

Banner Payson Medical Center — Payson, AZ

Most expensive published cash price

$68,375.58

Baptist Health Paducah — Paducah, KY

Median cash price over time

Sep 1, 2025 ($2,662.48) → Sep 1, 2026 ($6,964.20)

By state

State Hospitals Lowest cash Median Highest
Alaska 4 $16,170.06 $27,523.51 $33,830.98
Arizona 12 $424.70 $1,999.54 $27,033.43
California 47 $1,608.39 $16,366.37 $45,440.26
Colorado 6 $1,198.26 $34,658.48 $34,658.48
Florida 9 $15,351.70 $43,548.70 $43,548.70
Georgia 21 $10,612.09 $22,121.61 $49,280.00
Illinois 7 $1,513.80 $7,992.00 $12,402.00
Indiana 5 $2,130.00 $15,486.60 $68,375.58
Iowa 22 $3,763.50 $3,961.09 $12,402.00
Kentucky 7 $15,151.97 $68,375.58 $68,375.58
Maine 3 $2,266.31 $2,662.48 $8,800.00
Maryland 1 $3,161.40 $3,161.40 $3,161.40
Michigan 11 $476.58 $1,377.04 $1,377.04
Minnesota 2 not published by hospital not published by hospital not published by hospital
Missouri 7 $2,139.09 $2,139.09 $2,321.42
Montana 1 $18,819.49 $18,819.49 $18,819.49
Nebraska 12 $3,974.40 $7,257.60 $7,344.00
Nevada 3 $483.58 $8,519.80 $9,434.12
New Hampshire 1 $13,870.50 $13,870.50 $13,870.50
New Jersey 19 $2,867.51 $2,867.51 $2,867.51
New Mexico 1 $28,035.16 $28,035.16 $28,035.16
New York 11 not published by hospital not published by hospital not published by hospital
North Carolina 12 $1,375.00 $1,375.00 $1,375.00
North Dakota 1 not published by hospital not published by hospital not published by hospital
Ohio 53 $911.25 $5,098.58 $18,991.01
Oklahoma 1 $1,835.25 $1,835.25 $1,835.25
Oregon 9 $7,938.00 $29,442.21 $29,442.21
Pennsylvania 10 $2,221.80 $4,449.60 $33,312.60
South Carolina 7 $7,013.50 $7,095.00 $12,168.00
South Dakota 1 not published by hospital not published by hospital not published by hospital
Tennessee 1 $1,183.07 $1,183.07 $1,183.07
Texas 34 $1,396.50 $23,308.05 $28,035.16
Virginia 14 $1,008.15 $2,641.00 $5,216.40
Washington 21 $784.40 $24,465.34 $35,933.47
West Virginia 5 $513.50 $1,047.41 $11,345.00
Wyoming 2 $544.13 $544.13 $6,456.45

All hospitals

Hospital Location Cash price Negotiated range
Banner Payson Medical Center Payson, AZ $424.70 $121.19 – $756.90
Henry Ford Rochester Hospital Rochester, MI $476.58 $57.17 – $57.17
Banner Churchill Community Hospital Fallon, NV $483.58 $218.66 – $807.36
Banner University Medical Center Tucson Tucson, AZ $484.01 $121.19 – $794.49
Jackson General Hospital Ripley, WV $513.50 not published
Community Hospital Torrington, WY $544.13 $370.04 – $815.77
Camden Clark Medical Center Parkersburg, WV $758.14 not published
MultiCare Allenmore Hospital Tacoma, WA $784.40 not published
Arizona General Hospital Laveen Phoenix, AZ $869.75 $279.44 – $1,630.74
University Hospitals Beachwood Medical Center Beachwood, OH $911.25 $404.60 – $1,093.50
University Hospitals Conneaut Medical Center Conneaut, OH $911.25 not published
University Hospitals Elyria Medical Center Elyria, OH $911.25 not published
University Hospitals Geneva Medical Center Geneva, OH $911.25 not published
University Hospitals St. John Medical Center Westlake OH, OH $911.25 not published
University Hospitals Samaritan Medical Center Ashland, OH $911.25 not published
University Hospitals Lake West Medical Center Willoughby OH 44094|7590 Auburn Road, OH $911.25 not published
University Hospitals Parma Medical Center Parma OH 44129|7007 Powers Boulevard, OH $911.25 not published
University Hospitals Portage Medical Center Ravenna OH 44266, OH $911.25 not published
University Hospitals Cleveland Medical Center Cleveland OH 44106|3999 Richmond Road, OH $911.25 not published
University Hospitals Regional Hospitals - Geauga Medical Center Chardon, OH $911.25 not published
University Hospitals Ahuja Medical Center Beachwood, OH $911.25 $268.52 – $1,093.50
Arizona General Hospital Mesa Mesa, AZ $938.11 $279.44 – $1,630.74
Henry Ford Genesys Hospital Grand Blanc Twp, MI $974.40 $78.14 – $78.14
Sentara Martha Jefferson Hospital Charlottesville, VA $1,008.15 not published
Sentara RMH Medical Center Harrisonburg, VA $1,008.15 not published
Riverside Methodist Hospital Columbus, OH $1,030.87 not published
Dublin Methodist Hospital Dublin, OH $1,030.87 not published
Grant Medical Center Columbus, OH $1,030.87 not published
Doctors Hospital Columbus, OH $1,030.87 not published
Berkeley Medical Center Martinsburg, WV $1,047.41 not published
Franklin Woods Community Hospital JOHNSON CITY, TN $1,183.07 $23.97 – $23.97
Banner North Colorado Medical Center - Loveland Campus Loveland, CO $1,198.26 $17.99 – $66.50
West Virginia University Hospitals Morgantown, WV $1,371.05 not published
Atrium Health Anson Wadesboro, NC $1,375.00 $60.74 – $385.70
Atrium Health Mercy Charlotte, NC $1,375.00 $72.96 – $373.52
Atrium Health Pineville Charlotte, NC $1,375.00 $40.60 – $373.52
Atrium Health Stanly Albermarle, NC $1,375.00 $48.72 – $389.76
Atrium Health Behavioral Health Charlotte Charlotte, NC $1,375.00 $77.14 – $406.00
Atrium Health Cleveland Shelby, NC $1,375.00 $56.84 – $385.70
Atrium Health Cabarrus Concord, NC $1,375.00 $49.82 – $385.70
Atrium Health Lincoln Lincolnton, NC $1,375.00 $45.80 – $385.70
Atrium Health Union Monroe, NC $1,375.00 $52.78 – $385.70
Carolinas Rehabilitation Charlotte Charlotte, NC $1,375.00 $124.20 – $373.52
Atrium Health University City Charlotte, NC $1,375.00 $40.60 – $373.52
Atrium Health Carolinas Medical Center Charlotte, NC $1,375.00 $77.75 – $365.40
Henry Ford Providence Novi Hospital Novi, MI $1,377.04 $26.74 – $29.79
Henry Ford St John Hospital Detroit, MI $1,377.04 $22.14 – $221.10
Henry Ford River District Hospital China Township, MI $1,377.04 $221.10 – $221.10
Henry Ford Warren Hospital Warren, MI $1,377.04 $221.10 – $221.10
St. Luke's Health - The Vintage Hospital Houston, TX $1,396.50 $739.20 – $3,360.00

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