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 |
|---|---|---|---|
| Ascension St. John Medical Center (St. John Medical Center, Inc.) | Tulsa, OK | $543.12 | $183.04 – $183.04 |
| Ascension St. John Jane Phillips (Jane Phillips Memorial Medical Center, Inc.) | Bartlesville, OK | $543.12 | $183.04 – $225.04 |
| Ascension St. John Nowata (Jane Phillips Nowata Hospital, Inc.) | Nowata, OK | $543.12 | $210.04 – $225.04 |
| Ascension St. John Sapulpa (St. John Sapulpa, Inc.) | Sapulpa, OK | $543.12 | $210.04 – $225.04 |
| Adventhealth Wesley Chapel | Wesley Chapel, FL | $543.15 | not published |
| martin north hospital | Stuart, FL | $543.40 | $24.90 – $198.19 |
| Ascension Saint Thomas River Park | McMinnville, TN | $543.99 | $61.98 – $290.74 |
| Banner Del Webb Medical Center | Sun City West, AZ | $544.31 | $67.05 – $372.24 |
| Sanford Medical Center Bismarck | Bismarck, ND | $546.34 | $69.93 – $198.47 |
| OSF Saint Elizabeth Medical Center | Ottawa, IL | $569.40 | not published |
| OSF St Mary Medical Center | Galesburg, IL | $569.40 | not published |
| indian river hospital | Vero Beach, FL | $572.00 | $42.90 – $198.19 |
| Boca Raton Regional Hospital | BOCA RATON, FL | $573.95 | $0.02 – $406.82 |
| Henry Ford Rochester Hospital | Rochester, MI | $576.69 | $202.46 – $566.00 |
| OSF Saint Anthony Medical Center | Rockford, IL | $580.20 | $132.89 – $466.75 |
| Uniontown Hospital | Uniontown, PA | $587.00 | $126.52 – $294.79 |
| OSF Sacred Heart Medical Center – Urbana | Danville, IL | $588.60 | not published |
| OSF St Joseph Medical Center | Bloomington, IL | $588.60 | not published |
| Banner Ocotillo Medical Center | Chandler, AZ | $592.46 | $67.05 – $739.22 |
| Ascension Sacred Heart Bay (Bay County Health System, Inc.) | Panama City, FL | $595.60 | $166.37 – $435.51 |
| Sanford Bemidji Medical Center | Bemidji, MN | $596.00 | $1.02 – $92.48 |
| OSF Saint Francis Medical Center | Peoria, IL | $597.60 | $132.89 – $453.36 |
| Banner University Medical Center Phoenix | Phoenix, AZ | $598.74 | $29.66 – $287.59 |
| Rochester General Hospital | Rochester, NY | $600.60 | $138.74 – $306.91 |
| Newark Wayne Community Hospital | Newark, NY | $600.60 | $120.89 – $306.91 |
| Mercy Hospital Southeast | Cape Girardeau, MO | $627.90 | $83.91 – $799.71 |
| Ascension Saint Thomas Rutherford | Murfreesboro, TN | $635.07 | $172.83 – $290.74 |
| MUSC Health Black River Medical Center | Cades, SC | $635.50 | $115.74 – $205.44 |
| MUSC Health Main Campus - Charleston | Charleston, SC | $635.50 | $115.74 – $307.94 |
| MUSC Health Florence Medical Center | Florence, SC | $635.50 | $115.74 – $205.44 |
| MUSC Health Orangeburg Medical Center | Orangeburg, SC | $635.50 | not published |
| MUSC Health Lancaster Medical Center | Lancaster, SC | $635.50 | $120.93 – $205.44 |
| Mansfield Hospital | Mansfield, OH | $636.25 | $118.83 – $123.58 |
| Shelby Hospital | Shelby, OH | $636.25 | $231.50 – $231.50 |
| Sanford Luverne Medical Center | Luverne, MN | $636.80 | $117.42 – $436.50 |
| MercyOne Centerville Medical Center | Centerville, IA | $637.00 | $83.94 – $305.89 |
| Riverside Methodist Hospital | Columbus, OH | $644.40 | $119.99 – $376.01 |
| Dublin Methodist Hospital | Dublin, OH | $644.40 | $119.99 – $376.01 |
| Grant Medical Center | Columbus, OH | $644.40 | $119.99 – $376.01 |
| Doctors Hospital | Columbus, OH | $644.40 | $122.62 – $376.01 |
| MUSC Health Kershaw Medical Center | Camden, SC | $656.50 | $120.29 – $205.44 |
| O'Bleness Hospital | Athens, OH | $658.88 | $118.83 – $120.01 |
| Van Wert Hospital | Van Wert, OH | $658.88 | $127.79 – $130.34 |
| Grady Memorial Hospital | Delaware, OH | $658.88 | $119.99 – $124.79 |
| Berger Hospital | Circleville, OH | $658.88 | $119.99 – $235.88 |
| Southeastern Medical Center | Cambridge, OH | $658.88 | $117.73 – $122.44 |
| Hardin Memorial Hospital | Kenton, OH | $658.88 | $235.88 – $235.88 |
| Marion General Hospital | Marion, OH | $658.88 | $118.83 – $123.58 |
| Sanford Worthington Medical Center | Worthington, MN | $682.40 | $1.00 – $290.70 |
| Mercy Hospital Oklahoma City | Oklahoma City, OK | $682.50 | $118.37 – $334.63 |