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
Baylor St Luke's Medical Center Houston, TX $1,396.50 $739.20 – $3,360.00
St. Luke's Health - Sugar Land Hospital Sugar Land, TX $1,396.50 $739.20 – $3,360.00
St. Luke's Health - Springwoods Village Hospital Spring, TX $1,396.50 $739.20 – $3,360.00
St. Luke's Health - Lakeside Hospital The Woodlands, TX $1,396.50 $739.20 – $3,360.00
Advocate Childrens Hospital - Park Ridge Park Ridge, IL $1,513.80 $1,056.63 – $2,422.08
TWIN CITIES COMMUNITY HOSPITAL Templeton, CA $1,608.39 $295.00 – $383.50
Southeastern Medical Center Cambridge, OH $1,657.87 not published
SSM Health St. Anthony Hospital - Oklahoma City Oklahoma City, OK $1,835.25 not published
Advocate South Suburban Hospital Hazel Crest, IL $1,842.66 $1,153.51 – $2,948.26
Banner Estrella Medical Center Phoenix, AZ $1,915.64 $121.19 – $931.24
Banner University Medical Center Phoenix Phoenix, AZ $1,999.54 $121.19 – $630.75
Ascension St. Vincent Kokomo (St. Joseph Hospital & Health Center, Inc.) Kokomo, IN $2,130.00 $14.12 – $108.92
SSM Health DePaul Hospital - St. Louis Bridgeton, MO $2,139.09 not published
SSM Health St. Joseph Hospital- Wentzville Wentzville, MO $2,139.09 not published
SSM Health St. Clare Hospital - Fenton Fenton, MO $2,139.09 not published
SSM Health St. Joseph Hospital - St. Charles Saint Charles, MO $2,139.09 not published
SSM Health St. Mary's Hospital - St. Louis Richmond Heights, MO $2,139.09 not published
SSM Health St. Joseph Hospital - Lake Saint Louis Lake Saint Louis, MO $2,139.09 not published
UPMC Muncy Muncy, PA $2,221.80 $555.45 – $3,332.70
Mid Coast Hospital Brunswick, ME $2,266.31 $187.09 – $250.16
Banner Baywood Medical Center Mesa, AZ $2,319.89 $5.58 – $931.24
SSM Health Saint Louis University Hospital Saint Louis, MO $2,321.42 not published
Banner Gateway Medical Center Gilbert, AZ $2,558.70 $121.19 – $931.24
Sentara Leigh Hospital Norfolk, VA $2,641.00 not published
Sentara Virginia Beach General Hospital Virginia Beach, VA $2,641.00 not published
Sentara Princess Anne Hospital Virginia Beach, VA $2,641.00 not published
Sentara Obici Hospital Suffolk, VA $2,641.00 not published
Sentara CarePlex Hospital Hampton, VA $2,641.00 not published
Sentara Northern Virginia Medical Center Woodbridge, VA $2,641.00 not published
Sentara Norfolk General Hospital Norfolk, VA $2,641.00 not published
Waldo County General Hospital Belfast, ME $2,662.48 $498.39 – $1,168.74
Robert Wood Johnson University Hospital New Brunswick, NJ $2,867.51 $43.16 – $44.63
UPMC Wellsboro Wellsboro, PA $2,929.80 $604.62 – $3,023.10
UPMC Williamsport Williamsport, PA $2,982.60 $265.00 – $1,192.50
SIERRA VISTA HOSPITAL, INC. San Luis Obispo, CA $3,146.04 $5,296.00 – $6,884.80
UPMC Western Maryland Cumberland, MD $3,161.40 $1,667.00 – $1,667.00
ST HELENA HOSPITAL Vallejo, CA $3,330.00 $22,200.00 – $22,200.00
MercyOne New Hampton Medical Center New Hampton, IA $3,763.50 $53.48 – $135.08
Banner Ironwood Medical Center San Tan Valley, AZ $3,882.35 $121.19 – $931.24
MercyOne Waterloo Medical Center Waterloo, IA $3,961.09 $22.76 – $113.80
MercyOne Dubuque Medical Center Dubuque, IA $3,961.09 $22.05 – $113.80
MercyOne Dyersville Medical Center Dyersville, IA $3,961.09 $43.02 – $128.09
MercyOne Clinton Medical Center Clinton, IA $3,961.09 $22.05 – $113.80
MercyOne Oelwein Medical Center Oelwein, IA $3,961.09 $43.49 – $113.80
MercyOne Cedar Falls Medical Center Cedar Falls, IA $3,961.09 $19.73 – $113.80
MercyOne Elkader Medical Center Elkader, IA $3,961.09 $58.57 – $118.94
MercyOne Des Moines Medical Center Des Moines, IA $3,961.09 $18.57 – $113.80
MercyOne Newton Medical Center Newton, IA $3,961.09 $22.76 – $113.80
MercyOne North Iowa Medical Center Mason City, IA $3,961.09 $22.76 – $113.80
CHI Health Nebraska Heart Lincoln, NE $3,974.40 $0.01 – $0.04

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