HCPCS Q4122
Dermacell, dermacell awm or dermacell awm porous, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products38 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 – $38,003 | $17,884 | $44,709 |
| Deaconess Medical Center | $229 – $32,638 | $17,884 | $44,709 |
| Harborview Medical Center | $231 – $307 | — | — |
| Highline Medical Center | $160 – $45,010 | $673 – $15,271 | $2,203 – $50,011 |
| Island Hospital | $193 – $267 | — | — |
| Kadlec Regional Medical Center | $234 – $460 | $4,135 | $5,907 |
| Legacy Salmon Creek Medical Center | $272 – $277 | $102 | $157 |
| Mary Bridge Children's Hospital | $1,000 – $36,393 | $17,884 | $44,709 |
| MultiCare Auburn Medical Center | $239 – $32,638 | $17,884 | $44,709 |
| MultiCare Covington Medical Center | $239 – $32,638 | $17,884 | $44,709 |
| MultiCare Good Samaritan Hospital | $240 – $32,638 | $17,884 | $44,709 |
| MultiCare Valley Hospital | $229 – $32,190 | $17,884 | $44,709 |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $159 – $380 | — | — |
| PeaceHealth St Joseph Medical Center | $244 | $6,527 | $10,042 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $121 – $460 | $5,314 | $7,591 |
| Providence Centralia Hospital | $244 – $539 | $8,665 | $16,663 |
| Providence Holy Family Hospital | $121 – $508 | $5,314 | $7,591 |
| Providence Mount Carmel Hospital | — | $5,076 | $7,251 |
| Providence Regional Medical Center Everett | $121 – $440 | $7,591 | $14,599 |
| Providence St Joseph Hospital | — | $5,076 | $7,251 |
| Providence St Mary Medical Center | — | $4,605 | $6,579 |
| Providence St Peter Hospital | — | $8,665 | $16,663 |
| St Anthony Hospital | $134 – $37,508 | $670 – $15,211 | $2,203 – $50,011 |
| St Clare Hospital | $134 – $37,508 | $635 – $14,415 | $2,203 – $50,011 |
| St Elizabeth Hospital | $149 – $45,010 | $778 – $17,672 | $2,203 – $50,011 |
| St Francis Community Hospital | $134 – $37,508 | $691 – $15,695 | $2,203 – $50,011 |
| St Joseph Medical Center | $134 – $37,508 | $730 – $16,563 | $2,203 – $50,011 |
| St Michael Medical Center | $1,410 – $45,010 | $972 – $22,072 | $2,203 – $50,011 |
| Swedish Edmonds Hospital | $121 – $510 | $5,152 | $10,733 |
| Swedish Issaquah | $121 – $613 | $5,152 | $10,733 |
| Swedish Medical Center | $121 – $611 | $5,152 | $10,733 |
| Swedish Medical Center / Cherry Hill | $121 – $611 | $5,152 | $10,733 |
| Tacoma General Allenmore Hospital | $240 – $32,638 | $17,884 | $44,709 |
| University of Washington Medical Ctr | $231 – $452 | — | — |
| Virginia Mason Medical Center | $115 | — | — |
| 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