HCPCS Q4116

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

Current codeSkin Substitute Products39 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS Q4116 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$238 – $70,1356 plans$234 – $33,005$586 – $82,512
Cascade Valley HospitalArlington$117 – $10,6047 plans$1,570 – $9,426$1,962 – $11,782
Deaconess Medical CenterSpokaneFile dated 2026-08-27$218 – $60,23410 plans$234 – $33,005$586 – $82,512
Harborview Medical CenterSeattleFile dated 2026-04-01$231 – $3073 plans$123 – $37,766$176 – $53,952
Highline Medical CenterBurienFile dated 2026-02-28$156 – $71,1316 plans$154 – $24,134$504 – $79,035
Island HospitalAnacortes$193 – $2675 plans——
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$85.54 – $26,951$122 – $38,501
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$379 – $67,1658 plans$234 – $33,005$586 – $82,512
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$239 – $60,2347 plans$234 – $33,005$586 – $82,512
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$239 – $60,2347 plans$234 – $33,005$586 – $82,512
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$240 – $60,2347 plans$234 – $33,005$586 – $82,512
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$218 – $59,40910 plans$234 – $33,005$586 – $82,512
Olympic Medical CenterPort AngelesFile dated 2026-06-24———
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$57.86 – $3806 plans$49.50 – $134$99.00 – $267
PeaceHealth Southwest Medical CenteVancouver$50.61 – $4104 plans$26,674$41,037
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$52.88 – $4609 plans$184 – $33,262$262 – $47,518
Providence Centralia HospitalCentraliaFile dated 2026-04-01$66.63 – $5395 plans$108 – $30,275$208 – $58,221
Providence Holy Family HospitalSpokaneFile dated 2026-04-01$52.88 – $5089 plans$184 – $33,262$262 – $47,518
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$173 – $31,946$247 – $45,638
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$52.88 – $44010 plans$115 – $42,287$221 – $81,322
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$173 – $31,946$247 – $45,638
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01$52.88 – $4085 plans$109 – $31,289$156 – $44,699
Providence St Peter HospitalOlympiaFile dated 2026-04-01$55.00 – $5599 plans$108 – $30,275$208 – $58,221
Skagit Valley HospitalMount Vernon$283 – $11,1937 plans$1,570 – $9,426$1,962 – $11,782
St Anthony HospitalGig HarborFile dated 2026-02-28$130 – $59,2764 plans$153 – $24,038$504 – $79,035
St Clare HospitalLakewoodFile dated 2026-02-28$130 – $59,2764 plans$145 – $22,781$504 – $79,035
St Elizabeth HospitalEnumclawFile dated 2026-02-28$145 – $71,13110 plans$178 – $27,928$504 – $79,035
St Francis Community HospitalFederal WayFile dated 2026-02-28$130 – $59,2764 plans$158 – $24,803$504 – $79,035
St Joseph Medical CenterTacomaFile dated 2026-02-28$130 – $59,2764 plans$167 – $26,176$504 – $79,035
St Michael Medical CenterSilverdaleFile dated 2026-02-28$124 – $71,13110 plans$222 – $34,882$504 – $79,035
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$71.14 – $35,879$148 – $74,748
Swedish IssaquahIssaquahFile dated 2026-04-01—$71.14 – $35,879$148 – $74,748
Swedish Medical CenterSeattleFile dated 2026-04-01—$71.14 – $35,879$148 – $74,748
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$71.14 – $35,879$148 – $74,748
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$240 – $60,2347 plans$234 – $33,005$586 – $82,512
University of Washington Medical CtrSeattleFile dated 2026-04-01$231 – $4526 plans$35.94 – $33,840$51.35 – $48,343
Virginia Mason Medical CenterSeattle$49.20 – $1989 plans$41.82 – $126$82.00 – $248
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27$3671 plan——
Yakima Valley MemorialYakimaFile dated 2026-08-27$233 – $1,2229 plans$570$1,426

Lowest and highest amounts each hospital lists for this code as an outpatient, 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 6001)
Surgery center payment (national)
$127