HCPCS Q4114
Integra flowable wound matrix, injectable, 1 cc
Current codeSkin Substitute Products31 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $8,683 | $21,708 |
| Deaconess Medical Center | — | $8,683 | $21,708 |
| Highline Medical Center | — | $5,824 | $19,074 |
| Kadlec Regional Medical Center | — | $8,658 | $12,369 |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | $8,683 | $21,708 |
| MultiCare Auburn Medical Center | — | $8,683 | $21,708 |
| MultiCare Covington Medical Center | — | $8,683 | $21,708 |
| MultiCare Good Samaritan Hospital | — | $8,683 | $21,708 |
| MultiCare Valley Hospital | — | $8,683 | $21,708 |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $11,304 | $16,149 |
| Providence Centralia Hospital | — | $12,193 | $23,448 |
| Providence Holy Family Hospital | — | $11,304 | $16,149 |
| Providence Mount Carmel Hospital | — | $10,833 | $15,476 |
| Providence Regional Medical Center Everett | — | $15,089 | $29,017 |
| Providence St Joseph Hospital | — | $10,833 | $15,476 |
| Providence St Mary Medical Center | — | $10,177 | $14,538 |
| Providence St Peter Hospital | — | $12,193 | $23,448 |
| St Anthony Hospital | — | $5,801 | $19,074 |
| St Clare Hospital | — | $5,498 | $19,074 |
| St Elizabeth Hospital | $3,243 – $3,948 | $6,740 | $19,074 |
| St Francis Community Hospital | — | $5,986 | $19,074 |
| St Joseph Medical Center | — | $6,317 | $19,074 |
| St Michael Medical Center | — | $8,418 | $19,074 |
| Swedish Edmonds Hospital | — | $11,368 | $23,683 |
| Swedish Issaquah | — | $11,368 | $23,683 |
| Swedish Medical Center | — | $11,368 | $23,683 |
| Swedish Medical Center / Cherry Hill | — | $11,368 | $23,683 |
| Tacoma General Allenmore Hospital | — | $8,683 | $21,708 |
| Yakima Valley Memorial | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.