HCPCS Q4116
Alloderm, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products39 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $141 – $155 | $234 – $33,005 | $586 – $82,512 |
| Cascade Valley Hospital | $1,962 – $11,782 | $1,570 – $9,426 | $1,962 – $11,782 |
| Deaconess Medical Center | $136 – $149 | $234 – $33,005 | $586 – $82,512 |
| Harborview Medical Center | $144 – $159 | $123 – $37,766 | $176 – $53,952 |
| Highline Medical Center | — | $154 – $24,134 | $504 – $79,035 |
| Island Hospital | $149 – $157 | — | — |
| Kadlec Regional Medical Center | — | $85.54 – $26,951 | $122 – $38,501 |
| Mary Bridge Children's Hospital | $142 – $157 | $234 – $33,005 | $586 – $82,512 |
| MultiCare Auburn Medical Center | $142 – $156 | $234 – $33,005 | $586 – $82,512 |
| MultiCare Covington Medical Center | $142 – $156 | $234 – $33,005 | $586 – $82,512 |
| MultiCare Good Samaritan Hospital | $142 – $157 | $234 – $33,005 | $586 – $82,512 |
| MultiCare Valley Hospital | $140 – $149 | $234 – $33,005 | $586 – $82,512 |
| Olympic Medical Center | $156 – $201 | — | — |
| Overlake Hospital Medical Center & Clinics | $145 – $150 | $49.50 – $134 | $99.00 – $267 |
| PeaceHealth Southwest Medical Cente | $127 – $146 | $26,674 | $41,037 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $139 – $166 | $184 – $33,262 | $262 – $47,518 |
| Providence Centralia Hospital | $144 – $231 | $108 – $30,275 | $208 – $58,221 |
| Providence Holy Family Hospital | $139 – $153 | $184 – $33,262 | $262 – $47,518 |
| Providence Mount Carmel Hospital | — | $173 – $31,946 | $247 – $45,638 |
| Providence Regional Medical Center Everett | $142 – $156 | $115 – $42,287 | $221 – $81,322 |
| Providence St Joseph Hospital | — | $173 – $31,946 | $247 – $45,638 |
| Providence St Mary Medical Center | $139 – $153 | $109 – $31,289 | $156 – $44,699 |
| Providence St Peter Hospital | $143 – $229 | $108 – $30,275 | $208 – $58,221 |
| Skagit Valley Hospital | — | $1,570 – $9,426 | $1,962 – $11,782 |
| St Anthony Hospital | — | $153 – $24,038 | $504 – $79,035 |
| St Clare Hospital | — | $145 – $22,781 | $504 – $79,035 |
| St Elizabeth Hospital | $90.72 – $17,388 | $178 – $27,928 | $504 – $79,035 |
| St Francis Community Hospital | — | $158 – $24,803 | $504 – $79,035 |
| St Joseph Medical Center | — | $167 – $26,176 | $504 – $79,035 |
| St Michael Medical Center | — | $222 – $34,882 | $504 – $79,035 |
| Swedish Edmonds Hospital | — | $71.14 – $35,879 | $148 – $74,748 |
| Swedish Issaquah | — | $71.14 – $35,879 | $148 – $74,748 |
| Swedish Medical Center | — | $71.14 – $35,879 | $148 – $74,748 |
| Swedish Medical Center / Cherry Hill | — | $71.14 – $35,879 | $148 – $74,748 |
| Tacoma General Allenmore Hospital | $142 – $157 | $234 – $33,005 | $586 – $82,512 |
| University of Washington Medical Ctr | $144 – $159 | $35.94 – $33,840 | $51.35 – $48,343 |
| Virginia Mason Medical Center | — | $41.82 – $126 | $82.00 – $248 |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $146 – $163 | $570 | $1,426 |
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