Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm cost at US hospitals
GRAFT SFT TISS GRAFIX AMNIO PRIME 3X4CM 12SQCM-Q4133-COST PER SQ CM · HCPCS Q4133
$105.57
lowest cash price
$1,132.47
national median
$14,976.00
highest cash price
543
hospitals with a published cash price
Middle half of hospitals (25th–75th percentile) against the full range. The same procedure varies $105.57–$14,976.00 — the variation is the story.
Median cash price over time
Sep 1, 2025 ($2,655.50) → Sep 1, 2026 ($742.50)
By state
| State | Hospitals | Lowest cash | Median | Highest |
|---|---|---|---|---|
| Alaska | 1 | $12,425.40 | $12,425.40 | $12,425.40 |
| Arizona | 16 | $114.00 | $181.72 | $5,573.06 |
| Arkansas | 7 | $323.05 | $334.10 | $771.00 |
| California | 72 | $119.10 | $6,630.00 | $14,518.08 |
| Colorado | 15 | $248.94 | $438.83 | $776.69 |
| Florida | 47 | $543.15 | $1,017.82 | $6,329.68 |
| Georgia | 22 | $251.15 | $5,089.62 | $13,133.38 |
| Hawaii | 1 | $705.38 | $705.38 | $705.38 |
| Illinois | 37 | $155.93 | $588.60 | $6,142.80 |
| Indiana | 14 | $3,468.00 | $5,781.00 | $6,057.00 |
| Iowa | 31 | $277.60 | $414.05 | $6,142.80 |
| Kansas | 4 | $403.65 | $403.65 | $403.65 |
| Kentucky | 17 | $863.55 | $10,595.70 | $10,595.70 |
| Louisiana | 6 | not published by hospital | not published by hospital | not published by hospital |
| Maine | 7 | $2,655.50 | $2,655.50 | $2,655.50 |
| Maryland | 1 | not published by hospital | not published by hospital | not published by hospital |
| Michigan | 25 | $171.12 | $576.69 | $1,904.00 |
| Minnesota | 5 | $348.00 | $596.00 | $682.40 |
| Missouri | 16 | $627.90 | $2,369.10 | $2,369.10 |
| Montana | 2 | $11,520.00 | $11,520.00 | $11,520.00 |
| Nebraska | 12 | $2,940.00 | $3,220.00 | $5,950.00 |
| Nevada | 3 | $1,615.90 | $10,112.86 | $11,198.14 |
| New Hampshire | 1 | $3,350.00 | $3,350.00 | $3,350.00 |
| New Jersey | 21 | $289.98 | $340.24 | $479.49 |
| New Mexico | 1 | not published by hospital | not published by hospital | not published by hospital |
| New York | 17 | $127.14 | $127.14 | $739.20 |
| North Carolina | 14 | $310.36 | $1,250.00 | $1,250.00 |
| North Dakota | 2 | $546.34 | $546.34 | $715.20 |
| Ohio | 47 | $119.50 | $1,235.00 | $6,075.00 |
| Oklahoma | 9 | $332.80 | $543.12 | $5,056.08 |
| Oregon | 4 | $212.16 | $4,556.00 | $5,540.40 |
| Pennsylvania | 14 | $236.00 | $417.60 | $3,681.60 |
| South Carolina | 9 | $635.50 | $635.50 | $778.00 |
| South Dakota | 3 | $792.00 | $794.40 | $1,589.60 |
| Tennessee | 33 | $330.93 | $1,520.10 | $4,900.50 |
| Texas | 98 | $167.06 | $1,132.47 | $10,254.00 |
| Virginia | 32 | $105.57 | $742.50 | $14,394.15 |
| Washington | 15 | $3,182.51 | $6,215.60 | $14,976.00 |
| West Virginia | 17 | $119.50 | $143.50 | $10,595.70 |
| Wisconsin | 31 | $159.20 | $1,007.99 | $4,770.00 |
| Wyoming | 2 | $195.43 | $195.43 | $502.04 |
All hospitals
| Hospital | Location | Cash price | Negotiated range |
|---|---|---|---|
| Sentara Halifax Regional Hospital | South Boston, VA | $105.57 | not published |
| Banner Casa Grande Medical Center | Casa Grande, AZ | $114.00 | $44.70 – $432.90 |
| SAN JOAQUIN COMMUNITY HOSPITAL | Bakersfield, CA | $119.10 | $139.47 – $648.74 |
| Braxton County Memorial Hospital | Gassaway, WV | $119.50 | $224.93 – $224.93 |
| Barnesville Hospital | Barnesville, OH | $119.50 | $224.93 – $224.93 |
| Jackson General Hospital | Ripley, WV | $119.50 | $224.93 – $224.93 |
| Jefferson Medical Center | Ranson, WV | $119.50 | $224.93 – $224.93 |
| Potomac Valley Hospital | Keyser, WV | $119.50 | $224.93 – $224.93 |
| St. Joseph's Hospital | Buckhannon, WV | $119.50 | $224.93 – $224.93 |
| Summersville Regional Medical Center | Summersville, WV | $119.50 | $224.93 – $224.93 |
| Bellevue Hospital Center | NY 10016, NY | $127.14 | $128.93 – $310.68 |
| Kings County Hospital Center | Brooklyn, NY | $127.14 | $128.93 – $310.68 |
| Woodhull Medical Center | Brooklyn, NY | $127.14 | $128.93 – $310.68 |
| Queens Hospital Center | Jamaica, NY | $127.14 | $128.93 – $310.68 |
| Banner University Medical Center South | Tucson, AZ | $131.21 | $29.66 – $444.20 |
| United Hospital Center | Bridgeport, WV | $143.50 | $126.52 – $224.93 |
| Princeton Community Hospital | Princeton, WV | $143.50 | $126.52 – $736.93 |
| Wetzel County Hospital | New Martinsville, WV | $143.50 | $126.52 – $224.93 |
| Weirton Medical Center | Weirton, WV | $143.50 | $126.52 – $643.91 |
| HANFORD COMMUNITY HOSPITAL | Selma, CA | $151.24 | $139.47 – $589.24 |
| REEDLEY COMMUNITY HOSPITAL | Reedley, CA | $151.24 | $69.00 – $475.89 |
| Ascension Saint Joseph - Chicago (Presence Chicago Hospital Network) | Chicago, IL | $155.93 | $277.50 – $277.50 |
| UnityPoint Health - Meriter Hospital | Madison, WI | $159.20 | $45.77 – $169.15 |
| Banner Boswell Medical Center | Sun City, AZ | $163.15 | $44.70 – $564.45 |
| Methodist Charlton Medical Center | Dallas, TX | $167.06 | $122.27 – $330.14 |
| Methodist Dallas Medical Center | Dallas, TX | $167.06 | $125.01 – $337.53 |
| Methodist Mansfield Medical Center | Mansfield, TX | $167.06 | $125.01 – $338.09 |
| Methodist Midlothian Medical Center | Midlothian, TX | $167.06 | $125.01 – $337.53 |
| Methodist Richardson Medical Center | Richardson, TX | $167.06 | $125.01 – $337.53 |
| Methodist Celina Medical Center | Celina, TX | $167.06 | $125.01 – $312.53 |
| Methodist Southlake Medical Center | Souhtlake, TX | $167.06 | $125.22 – $338.09 |
| Henry Ford Hospital | Detroit MI 48202 | 19401 Hubbard Dr., MI | $171.12 | $66.49 – $445.50 |
| Henry Ford West Bloomfield Hospital | West Bloomfield, MI | $171.12 | $66.49 – $445.50 |
| Henry Ford Wyandotte Hospital: | Wyandotte, MI | $171.12 | $66.49 – $528.75 |
| Henry Ford Macomb Hospital | Clinton Twp, MI | $171.12 | $66.49 – $526.37 |
| Banner Thunderbird Medical Center | Glendale, AZ | $174.42 | $29.66 – $287.59 |
| Banner Desert Medical Center | Mesa, AZ | $175.08 | $45.29 – $739.22 |
| Banner Ironwood Medical Center | San Tan Valley, AZ | $179.73 | $67.05 – $739.22 |
| Banner Baywood Medical Center | Mesa, AZ | $180.39 | $67.05 – $739.22 |
| Banner Estrella Medical Center | Phoenix, AZ | $181.72 | $44.70 – $739.22 |
| HSHS St. Francis Hospital | LITCHFIELD, IL | $190.80 | $209.78 – $265.00 |
| Grant Memorial Hospital | Petersburg, WV | $191.20 | $224.93 – $224.93 |
| Banner University Medical Center Tucson | Tucson, AZ | $194.98 | $29.66 – $630.67 |
| Banner Wyoming Medical Center | Casper, WY | $195.43 | $125.63 – $451.34 |
| Sentara Leigh Hospital | Norfolk, VA | $198.64 | not published |
| Sentara Virginia Beach General Hospital | Virginia Beach, VA | $198.64 | not published |
| Sentara Princess Anne Hospital | Virginia Beach, VA | $198.64 | not published |
| Sentara Obici Hospital | Suffolk, VA | $198.64 | not published |
| Sentara CarePlex Hospital | Hampton, VA | $198.64 | not published |
| Sentara Northern Virginia Medical Center | Woodbridge, VA | $198.64 | $123.85 – $193.78 |