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
WHITE MEMORIAL MEDICAL CENTER MONTEBELLO, CA $3,996.00 $1,600.00 – $77,700.00
CHI Health Mercy Corning Corning, IA $4,147.20 $0.02 – $0.04
CHI Health Missouri Valley Missouri Valley, IA $4,233.60 $0.02 – $0.04
CHI Health St. Elizabeth Lincoln, NE $4,320.00 $0.01 – $0.04
UPMC St. Margaret Pittsburgh, PA $4,444.20 $4,422.77 – $4,422.77
UPMC McKeesport Mckeesport, PA $4,449.60 $3,604.33 – $3,604.33
Berger Hospital Circleville, OH $4,528.30 not published
UPMC Magee Pittsburgh, PA $4,552.20 $3,604.33 – $3,604.33
RIDEOUT MEMORIAL HOSPITAL Marysville, CA $4,884.00 $14,700.00 – $14,700.00
CHI Health St. Francis Grand Island, NE $5,097.60 $0.01 – $0.04
Mansfield Hospital Mansfield, OH $5,098.58 not published
Shelby Hospital Shelby, OH $5,098.58 not published
Inova Alexandria Hospital Alexandria, VA $5,216.40 $1,241.45 – $1,241.45
Inova Fairfax Hospital Falls Church, VA $5,216.40 $1,241.45 – $1,241.45
Inova Fair Oaks Hospital VA 22033-1709, VA $5,216.40 $1,241.45 – $1,241.45
Inova Loudoun Hospital Leesburg, VA $5,216.40 $1,241.45 – $1,241.45
Inova Mount Vernon Hospital Alexandria, VA $5,216.40 $1,241.45 – $1,241.45
CHI Health Good Samaritan Kearney, NE $5,270.40 $0.01 – $0.04
ADVENTIST HEALTH TULARE Tulare, CA $5,744.08 $17,184.00 – $22,511.04
ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA $5,994.00 $14,700.00 – $18,036.90
MercyOne West Des Moines Medical Center West Des Moines, IA $6,093.98 $18.57 – $113.80
MercyOne Centerville Medical Center Centerville, IA $6,093.98 $31.23 – $113.80
UPMC Cole Coudersport, PA $6,451.80 $916.70 – $2,645.60
Washakie Medical Center Worland, WY $6,456.45 $83.57 – $168.88
St. Joseph's Medical Center Stockton Stockton, CA $6,555.62 $146.38 – $563.00
St. Luke's Health - Patients Medical Center Pasadena, TX $6,748.04 $179.05 – $639.45
UPMC Passavant-McCandless Pittsburgh, PA $6,838.20 $5,230.33 – $5,230.33
Ascension St. Vincent Evansville (St. Mary's Health, Inc.) IN 47750|10388 Warrick Wellness Trail Newburgh, IN $6,964.20 $14.12 – $108.92
MUSC Health Florence Medical Center Florence, SC $7,013.50 not published
MUSC Health Lancaster Medical Center Lancaster, SC $7,013.50 not published
MUSC Health Black River Medical Center Cades, SC $7,095.00 not published
MUSC Health Main Campus - Charleston Charleston, SC $7,095.00 not published
MUSC Health Orangeburg Medical Center Orangeburg, SC $7,095.00 not published
Northridge Hospital Medical Center Northridge, CA $7,168.35 $218.40 – $1,092.00
CHI Health St. Mary's Nebraska City, NE $7,171.20 $0.01 – $0.04
Mercy Medical Center Redding Redding, CA $7,201.94 $381.92 – $1,736.00
CHI Health Plainview Plainview, NE $7,257.60 $1,369.76 – $3,040.86
Mark Twain Medical Center San Andreas, CA $7,277.39 $584.93 – $2,215.78
CHI Health Mercy Council Bluffs Council Bluffs, IA $7,299.60 $0.01 – $0.04
CHI Health Creighton University Medical Center - Bergan Mercy Omaha, NE $7,299.60 $0.01 – $0.04
Lasting Hope Recovery Center Omaha, NE $7,299.60 $0.01 – $0.04
CHI Health Immanuel Omaha, NE $7,299.60 $0.01 – $0.04
CHI Health Lakeside Omaha, NE $7,299.60 $0.01 – $0.04
CHI Health Midlands Papillion, NE $7,299.60 $0.01 – $0.04
CHI Health Schuyler Schuyler, NE $7,344.00 $0.01 – $0.05
St. Clare Hospital Lakewood, WA $7,510.03 $2,129.55 – $3,194.33
Marion General Hospital Marion, OH $7,686.93 not published
St. Anthony Hospital Gig Harbor, WA $7,924.50 $2,129.55 – $3,194.33
NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK Tillamook, OR $7,938.00 $14,700.00 – $14,700.00
St. Anne Hospital Burien, WA $7,955.95 $1,831.42 – $3,833.19

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