HCPCS Q4101
Apligraf, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products43 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $238 – $7,263 | $3,418 | $8,545 |
| Cascade Valley Hospital | $15.30 – $3,632 | $144 – $3,228 | $180 – $4,035 |
| Deaconess Medical Center | $229 – $6,238 | $3,418 | $8,545 |
| EvergreenHealth Medical Center | $30.36 – $363 | $134 | $168 |
| EvergreenHealth Monroe | $106 – $156 | $134 | $168 |
| Harborview Medical Center | $231 – $307 | $4,176 | $5,966 |
| Highline Medical Center | $104 – $8,146 | $73.67 – $2,764 | $241 – $9,051 |
| Island Hospital | $193 – $3,319 | $388 – $3,494 | $388 – $3,494 |
| Kadlec Regional Medical Center | $37.85 – $390 | $2,695 | $3,851 |
| Legacy Salmon Creek Medical Center | $47.61 – $277 | — | — |
| Mary Bridge Children's Hospital | $1,000 – $6,956 | $3,418 | $8,545 |
| MultiCare Auburn Medical Center | $239 – $6,238 | $3,418 | $8,545 |
| MultiCare Covington Medical Center | $239 – $6,238 | $3,418 | $8,545 |
| MultiCare Good Samaritan Hospital | $240 – $6,238 | $3,418 | $8,545 |
| MultiCare Valley Hospital | $229 – $6,152 | $3,418 | $8,545 |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $56.69 – $380 | — | — |
| PeaceHealth Southwest Medical Cente | $50.61 – $410 | $44.20 – $1,945 | $68.00 – $2,992 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $33.46 – $460 | $2,917 | $4,167 |
| Providence Centralia Hospital | $84.47 – $539 | $4,787 | $9,206 |
| Providence Holy Family Hospital | $33.46 – $508 | $2,917 | $4,167 |
| Providence Mount Carmel Hospital | — | $2,785 | $3,978 |
| Providence Regional Medical Center Everett | $33.46 – $440 | $4,893 | $9,410 |
| Providence St Joseph Hospital | — | $2,785 | $3,978 |
| Providence St Mary Medical Center | $67.04 – $408 | $2,767 | $3,953 |
| Providence St Peter Hospital | $56.13 – $559 | $4,787 | $9,206 |
| Skagit Valley Hospital | $25.97 – $3,833 | $144 – $3,228 | $180 – $4,035 |
| St Anthony Hospital | $148 – $6,788 | $73.37 – $2,753 | $241 – $9,051 |
| St Clare Hospital | $148 – $6,788 | $69.54 – $2,609 | $241 – $9,051 |
| St Elizabeth Hospital | $80.33 – $8,146 | $85.25 – $3,198 | $241 – $9,051 |
| St Francis Community Hospital | $148 – $6,788 | $75.71 – $2,840 | $241 – $9,051 |
| St Joseph Medical Center | $148 – $6,788 | $79.90 – $2,998 | $241 – $9,051 |
| St Michael Medical Center | $60.60 – $8,146 | $106 – $3,994 | $241 – $9,051 |
| Swedish Edmonds Hospital | $33.46 – $510 | $2,968 | $6,184 |
| Swedish Issaquah | $33.46 – $613 | $67.46 – $2,968 | $141 – $6,184 |
| Swedish Medical Center | $33.46 – $611 | $67.46 – $2,968 | $141 – $6,184 |
| Swedish Medical Center / Cherry Hill | $33.46 – $611 | $67.46 – $2,968 | $141 – $6,184 |
| Tacoma General Allenmore Hospital | $240 – $6,238 | $3,418 | $8,545 |
| University of Washington Medical Ctr | $231 – $452 | $83.94 – $3,712 | $120 – $5,303 |
| Virginia Mason Medical Center | $70.80 – $94.40 | $60.18 | $118 |
| Wellfound Behavioral Health Hospital | $367 | — | — |
| WhidbeyHealth Medical Center | — | $151 – $508 | $151 – $508 |
| Yakima Valley Memorial | $233 – $353 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Doctor's fee, Seattle (King County)
- $156 in an office; $156 in a hospital or surgery center
- Doctor's fee, rest of Washington
- $134 in an office; $134 in a hospital or surgery center
- Hospital outpatient payment (national)
- $127 (APC 6000)
- Surgery center payment (national)
- $127