HCPCS Q4102
Oasis wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products42 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 – $644 | — | — |
| Cascade Valley Hospital | $3.40 – $480 | $32.00 | $40.00 |
| Deaconess Medical Center | $229 – $567 | — | — |
| EvergreenHealth Medical Center | $5.76 – $363 | $14.40 | $18.00 |
| Harborview Medical Center | $231 – $307 | $7,543 | $10,776 |
| Highline Medical Center | $2.37 – $42.01 | $1.69 – $14.26 | $5.51 – $46.67 |
| Island Hospital | $193 – $267 | — | — |
| Kadlec Regional Medical Center | $14.99 – $390 | $291 – $568 | $415 – $812 |
| Legacy Salmon Creek Medical Center | $18.72 – $277 | — | — |
| Mary Bridge Children's Hospital | $1,000 | — | — |
| MultiCare Auburn Medical Center | $239 – $597 | — | — |
| MultiCare Covington Medical Center | $239 – $597 | — | — |
| MultiCare Good Samaritan Hospital | $240 – $597 | — | — |
| MultiCare Valley Hospital | $229 – $566 | — | — |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $22.45 – $380 | — | — |
| PeaceHealth Southwest Medical Cente | $50.61 – $410 | $173 | $266 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $14.11 – $460 | $408 – $700 | $583 – $1,000 |
| Providence Centralia Hospital | $33.47 – $539 | $432 – $860 | $831 – $1,655 |
| Providence Holy Family Hospital | $14.11 – $508 | $408 – $700 | $583 – $1,000 |
| Providence Mount Carmel Hospital | — | $386 – $664 | $552 – $949 |
| Providence Regional Medical Center Everett | $14.11 – $440 | $478 – $947 | $920 – $1,820 |
| Providence St Joseph Hospital | — | $386 – $664 | $552 – $949 |
| Providence St Mary Medical Center | $26.56 – $408 | $336 – $618 | $480 – $883 |
| Providence St Peter Hospital | $22.21 – $559 | $432 – $860 | $831 – $1,655 |
| Skagit Valley Hospital | $5.77 – $38.00 | $32.00 | $40.00 |
| St Anthony Hospital | $3.97 – $35.01 | $1.68 – $14.20 | $5.51 – $46.67 |
| St Clare Hospital | $3.97 – $35.01 | $1.59 – $13.46 | $5.51 – $46.67 |
| St Elizabeth Hospital | $1.84 – $42.01 | $1.95 – $16.50 | $5.51 – $46.67 |
| St Francis Community Hospital | $3.97 – $35.01 | $1.73 – $14.65 | $5.51 – $46.67 |
| St Joseph Medical Center | $3.97 – $35.01 | $1.83 – $15.46 | $5.51 – $46.67 |
| St Michael Medical Center | $3.75 – $46.08 | $2.44 – $20.60 | $5.51 – $46.67 |
| Swedish Edmonds Hospital | $14.11 – $510 | $296 – $579 | $617 – $1,207 |
| Swedish Issaquah | $14.11 – $613 | $296 – $579 | $617 – $1,207 |
| Swedish Medical Center | $14.11 – $611 | $296 – $579 | $617 – $1,207 |
| Swedish Medical Center / Cherry Hill | $14.11 – $611 | $296 – $579 | $617 – $1,207 |
| Tacoma General Allenmore Hospital | $240 – $597 | — | — |
| University of Washington Medical Ctr | $231 – $452 | $6,705 | $9,578 |
| Virginia Mason Medical Center | $25.80 – $34.40 | $21.93 | $43.00 |
| Wellfound Behavioral Health Hospital | $367 | — | — |
| WhidbeyHealth Medical Center | — | $268 – $281 | $268 – $281 |
| 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 6001)
- Surgery center payment (national)
- $127