HCPCS Q4117
Hyalomatrix, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products31 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 – $14,755 | $410 – $6,944 | $1,025 – $17,359 |
| Deaconess Medical Center | $229 – $12,672 | $410 – $6,944 | $1,025 – $17,359 |
| EvergreenHealth Medical Center | $8.71 – $363 | $157 | $196 |
| Harborview Medical Center | $231 – $307 | — | — |
| Island Hospital | $193 – $267 | — | — |
| Kadlec Regional Medical Center | $89.79 – $390 | $383 – $5,536 | $547 – $7,908 |
| Legacy Salmon Creek Medical Center | $67.34 – $277 | — | — |
| Mary Bridge Children's Hospital | $662 – $14,130 | $410 – $6,944 | $1,025 – $17,359 |
| MultiCare Auburn Medical Center | $239 – $12,672 | $410 – $6,944 | $1,025 – $17,359 |
| MultiCare Covington Medical Center | $239 – $12,672 | $410 – $6,944 | $1,025 – $17,359 |
| MultiCare Good Samaritan Hospital | $240 – $12,672 | $410 – $6,944 | $1,025 – $17,359 |
| MultiCare Valley Hospital | $229 – $12,498 | $410 – $6,944 | $1,025 – $17,359 |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $45.37 – $380 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $24.97 – $460 | $538 – $7,524 | $769 – $10,748 |
| Providence Centralia Hospital | $89.79 – $539 | $570 – $12,579 | $1,096 – $24,191 |
| Providence Holy Family Hospital | $24.97 – $508 | $538 – $7,524 | $769 – $10,748 |
| Providence Mount Carmel Hospital | — | $509 – $7,196 | $728 – $10,280 |
| Providence Regional Medical Center Everett | $24.97 – $440 | $630 – $10,243 | $1,212 – $19,698 |
| Providence St Joseph Hospital | — | $509 – $7,196 | $728 – $10,280 |
| Providence St Mary Medical Center | — | $443 – $6,492 | $633 – $9,274 |
| Providence St Peter Hospital | — | $570 – $12,579 | $1,096 – $24,191 |
| Swedish Edmonds Hospital | $24.97 – $510 | $391 – $7,264 | $814 – $15,133 |
| Swedish Issaquah | $24.97 – $613 | $391 – $7,264 | $814 – $15,133 |
| Swedish Medical Center | $24.97 – $611 | $391 – $7,264 | $814 – $15,133 |
| Swedish Medical Center / Cherry Hill | $24.97 – $611 | $391 – $7,264 | $814 – $15,133 |
| Tacoma General Allenmore Hospital | $240 – $12,672 | $410 – $6,944 | $1,025 – $17,359 |
| University of Washington Medical Ctr | $231 – $452 | — | — |
| Virginia Mason Medical Center | $25.80 – $75.20 | $21.93 – $47.94 | $43.00 – $94.00 |
| Wellfound Behavioral Health Hospital | $367 | — | — |
| 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