HCPCS Q4101

Apligraf, per square centimeter (add-on, list separately in addition to primary procedure)

Current codeSkin Substitute Products43 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Unknown: The source file doesn't say which population this rate applies to.

Prices for HCPCS Q4101 by hospital
HospitalUnknown rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$3,418$8,545
Cascade Valley HospitalArlington—$144 – $3,228$180 – $4,035
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$3,418$8,545
EvergreenHealth Medical CenterKirkland$1511 plan$134$168
EvergreenHealth MonroeMonroe$116 – $1374 plans$134$168
Harborview Medical CenterSeattleFile dated 2026-04-01—$4,176$5,966
Highline Medical CenterBurienFile dated 2026-02-28—$73.67 – $2,764$241 – $9,051
Island HospitalAnacortes$149 – $1562 plans$388 – $3,494$388 – $3,494
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$2,695$3,851
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$3,418$8,545
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$3,418$8,545
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$3,418$8,545
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$3,418$8,545
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$3,418$8,545
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$2,917$4,167
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$4,787$9,206
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$2,917$4,167
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$2,785$3,978
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$4,893$9,410
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$2,785$3,978
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$2,767$3,953
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$4,787$9,206
Skagit Valley HospitalMount Vernon—$144 – $3,228$180 – $4,035
St Anthony HospitalGig HarborFile dated 2026-02-28—$73.37 – $2,753$241 – $9,051
St Clare HospitalLakewoodFile dated 2026-02-28—$69.54 – $2,609$241 – $9,051
St Elizabeth HospitalEnumclawFile dated 2026-02-28—$85.25 – $3,198$241 – $9,051
St Francis Community HospitalFederal WayFile dated 2026-02-28—$75.71 – $2,840$241 – $9,051
St Joseph Medical CenterTacomaFile dated 2026-02-28—$79.90 – $2,998$241 – $9,051
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$106 – $3,994$241 – $9,051
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$2,968$6,184
Swedish IssaquahIssaquahFile dated 2026-04-01—$67.46 – $2,968$141 – $6,184
Swedish Medical CenterSeattleFile dated 2026-04-01—$67.46 – $2,968$141 – $6,184
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$67.46 – $2,968$141 – $6,184
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$3,418$8,545
University of Washington Medical CtrSeattleFile dated 2026-04-01—$83.94 – $3,712$120 – $5,303
Virginia Mason Medical CenterSeattle—$60.18$118

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

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