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.

Cheapest published cash price

$105.57

Sentara Halifax Regional Hospital — South Boston, VA

Most expensive published cash price

$14,976.00

Providence Centralia Hospital — Centralia, WA

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
SSM Health St. Joseph Hospital - St. Charles Saint Charles, MO $2,369.10 $124.65 – $238.57
SSM Health St. Mary's Hospital - St. Louis Richmond Heights, MO $2,369.10 $124.65 – $238.57
SSM Health St. Joseph Hospital - Lake Saint Louis Lake Saint Louis, MO $2,369.10 $124.65 – $238.57
Northwestern Lake Forest Hospital DBA Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital Lake Forest, IL $2,369.58 not published
Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) Milwaukee, WI $2,387.65 $157.70 – $418.98
Ascension NE Wisconsin - St. Elizabeth Campus (Ascension NE Wisconsin, Inc.) Appleton, WI $2,492.61 $197.15 – $1,400.00
Ascension NE Wisconsin - Mercy Campus (Ascension NE Wisconsin, Inc.) Oshkosh, WI $2,492.61 $197.15 – $1,400.00
SIMI VALLEY HOSPITAL AND HEALTH CARE SERVICES Simi Valley, CA $2,592.00 $150.42 – $506.86
Lincoln Health Damariscotta, ME $2,655.50 $135.45 – $1,569.80
MercyOne Genesis Davenport West Medical Center Davenport, IA $2,767.80 not published
ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA $2,770.20 $134.06 – $266.43
WHITE MEMORIAL MEDICAL CENTER MONTEBELLO, CA $2,916.00 $127.97 – $953.19
CHI Health Mercy Council Bluffs Council Bluffs, IA $2,940.00 $27.27 – $154.53
CHI Health Creighton University Medical Center - Bergan Mercy Omaha, NE $2,940.00 $30.91 – $154.53
Lasting Hope Recovery Center Omaha, NE $2,940.00 $30.91 – $154.53
CHI Health Immanuel Omaha, NE $2,940.00 $25.46 – $154.53
CHI Health Lakeside Omaha, NE $2,940.00 $29.09 – $154.53
CHI Health Midlands Papillion, NE $2,940.00 $32.73 – $154.53
St. Joseph’s Hospital and Medical Center Phoenix, AZ $2,981.51 $57.68 – $475.16
Central Medical Center Seattle, WA $3,182.51 not published
WellSpan Ephrata Community Hospital Ephrata, PA $3,208.87 $138.74 – $477.30
CHI Health Nebraska Heart Lincoln, NE $3,220.00 $144.33 – $1,713.80
UKIAH ADVENTIST HOSPITAL Ukiah, CA $3,240.00 $134.06 – $975.44
MaineHealth - Memorial Hospital North Conway, NH $3,350.00 $135.45 – $186.68
CHI Health Mercy Corning Corning, IA $3,360.00 $143.23 – $1,568.49
Camden Clark Medical Center Parkersburg, WV $3,363.02 $126.52 – $221.41
Reynolds Memorial Hospital Glen Dale, WV $3,363.02 $82.24 – $224.93
West Virginia University Hospitals Morgantown, WV $3,363.02 $82.24 – $536.00
CHI Health Missouri Valley Missouri Valley, IA $3,430.00 $143.23 – $1,568.49
MEDICAL CITY FRISCO HOSPITAL Frisco, TX $3,442.00 $209.78 – $824.03
Ascension St. Vincent Evansville (St. Mary's Health, Inc.) IN 47750|10388 Warrick Wellness Trail Newburgh, IN $3,468.00 $37.56 – $142.43
CHI Health St. Elizabeth Lincoln, NE $3,500.00 $60.14 – $209.16
WellSpan Chambersburg Hospital Chambersburg, PA $3,645.98 $141.32 – $477.30
MercyOne Oelwein Medical Center Oelwein, IA $3,657.34 $116.91 – $305.89
UPMC Passavant-McCandless Pittsburgh, PA $3,681.60 $85.98 – $170.65
Ascension St. Vincent Kokomo (St. Joseph Hospital & Health Center, Inc.) Kokomo, IN $3,840.60 $37.56 – $142.43
MEDICAL CITY LAS COLINAS HOSPITAL Irving, TX $3,917.00 $209.78 – $824.03
ADVENTIST HEALTH TULARE Tulare, CA $3,917.99 $139.47 – $491.02
CHI Health St. Francis Grand Island, NE $4,130.00 $60.14 – $245.77
Claiborne Medical Center Tazewell, TN $4,158.00 $120.92 – $13,365.00
French Hospital San Luis Obispo, CA $4,235.56 $134.06 – $10,588.90
Northridge Hospital Medical Center Northridge, CA $4,240.53 $134.06 – $8,988.00
CHI Health Good Samaritan Kearney, NE $4,270.00 $110.25 – $488.25
LeConte Medical Center Sevierville, TN $4,306.50 $120.92 – $7,695.00
St. Luke's Health - Patients Medical Center Pasadena, TX $4,325.48 $87.98 – $314.22
Parkwest Medical Center Knoxville, TN $4,455.00 $112.91 – $4,095.00
Morristown-Hamblen Hospital Association Morristown, TN $4,455.00 $112.91 – $918.90
Sunnyside Medical Center CLACKAMAS, OR $4,556.00 not published
Westside Medical Center HILLSBORO, OR $4,556.00 not published
Arroyo Grande Hospital Santa Maria, CA $4,624.54 $134.06 – $10,588.90

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