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 |
|---|---|---|---|
| Sanford Thief River Falls Medical Center | Thief River Falls, MN | $348.00 | $60.11 – $157.50 |
| Sanford Behavioral Health Thief River Falls | Thief River Falls, MN | $348.00 | $60.11 – $157.50 |
| Monmouth Medical Center | Long Branch, NJ | $351.32 | $138.75 – $170.66 |
| Ascension Seton Smithville (Ascension Seton) | Smithville, TX | $357.84 | $134.11 – $134.11 |
| Robert Wood Johnson University Hospital Hamilton | Hamilton Township, NJ | $368.44 | $143.98 – $166.50 |
| lodi hospital | Lodi, OH | $375.70 | $127.14 – $520.20 |
| Henry Ford Genesys Hospital | Grand Blanc Twp, MI | $378.00 | $109.40 – $304.87 |
| Robert Wood Johnson University Hospital Somerset | Somerville, NJ | $379.90 | $73.69 – $166.50 |
| Monmouth Medical Center Southern Campus | Lakewood, NJ | $381.67 | $138.75 – $170.66 |
| Ascension Calumet Hospital, Inc. | Chilton, WI | $384.75 | $197.15 – $219.10 |
| UPMC Cole | Coudersport, PA | $385.20 | $138.74 – $513.60 |
| UPMC Northwest | Seneca, PA | $394.20 | $87.60 – $221.05 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland, OH | $398.45 | $173.36 – $551.70 |
| Mercy Hospital Pittsburg | Pittsburg, KS | $403.65 | $124.72 – $241.57 |
| UPMC Williamsport | Williamsport, PA | $410.40 | $138.74 – $152.61 |
| UPMC Altoona | Altoona, PA | $410.40 | $85.17 – $547.20 |
| MercyOne Waterloo Medical Center | Waterloo, IA | $414.05 | $61.18 – $305.89 |
| MercyOne Dubuque Medical Center | Dubuque, IA | $414.05 | $59.28 – $305.89 |
| MercyOne Dyersville Medical Center | Dyersville, IA | $414.05 | $115.63 – $344.31 |
| MercyOne Clinton Medical Center | Clinton, IA | $414.05 | $59.28 – $305.89 |
| MercyOne Cedar Falls Medical Center | Cedar Falls, IA | $414.05 | $53.04 – $305.89 |
| MercyOne Elkader Medical Center | Elkader, IA | $414.05 | $157.44 – $319.72 |
| MercyOne Des Moines Medical Center | Des Moines, IA | $414.05 | $49.92 – $305.89 |
| MercyOne Newton Medical Center | Newton, IA | $414.05 | $61.18 – $305.89 |
| MercyOne North Iowa Medical Center | Mason City, IA | $414.05 | $61.18 – $305.89 |
| UPMC Hamot | Erie, PA | $417.60 | $85.17 – $87.60 |
| UPMC Horizon-Greenville | Greenville, PA | $417.60 | $87.60 – $217.06 |
| UPMC Jameson | New Castle, PA | $417.60 | $86.67 – $140.13 |
| UPMC McKeesport | Mckeesport, PA | $417.60 | $85.98 – $154.14 |
| UPMC Mercy | Pittsburgh, PA | $417.60 | $85.17 – $138.74 |
| Trinitas Regional Medical Center | Elizabeth, NJ | $421.94 | $69.59 – $846.38 |
| Aurora Medical Center Kenosha | Kenosha, WI | $430.11 | $136.96 – $338.56 |
| Ascension Saint Thomas DeKalb | Smithville, TN | $433.50 | $61.98 – $290.74 |
| AdventHealth Parker | Parker, CO | $438.83 | $128.65 – $242.86 |
| AdventHealth Littleton | Littleton, CO | $438.83 | $128.65 – $242.86 |
| AdventHealth Avista | Louisville, CO | $438.83 | $130.08 – $245.55 |
| AdventHealth Porter | Denver, CO | $438.83 | $128.65 – $242.86 |
| AdventHealth Castle Rock | Castle Rock, CO | $438.83 | $128.65 – $242.86 |
| Ascension Saint Thomas Midtown | Nashville, TN | $440.90 | $172.83 – $290.74 |
| Ascension Saint Thomas Highlands | Sparta, TN | $441.84 | $61.98 – $290.74 |
| UnityPoint Health - St. Lukes Downtown | Sioux City, IA | $454.47 | $90.22 – $328.35 |
| Dell Seton Medical Center at The University of Texas (Ascension Seton) | Austin, TX | $454.68 | $134.11 – $134.11 |
| CHI Memorial Hospital Chattanooga | Chattanooga, TN | $472.92 | $64.89 – $309.00 |
| Robert Wood Johnson University Hospital | New Brunswick, NJ | $479.49 | $138.75 – $173.44 |
| Ascension Seton Cedar Park Hospital | Cedar Park, TX | $481.62 | $134.11 – $134.11 |
| OSF Little Company of Mary Medical Center | Evergreen Park, IL | $498.60 | not published |
| Washakie Medical Center | Worland, WY | $502.04 | $223.34 – $451.34 |
| MercyOne New Hampton Medical Center | New Hampton, IA | $515.72 | $125.78 – $317.70 |
| OSF Healthcare Saint Katharine Medical Center | Dixon, IL | $520.80 | not published |
| UnityPoint Health - Trinity Regional Medical Center | Fort Dodge, IA | $535.80 | $136.37 – $552.87 |