HCPCS Q4124
Oasis ultra tri-layer wound matrix, 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 – $644 | — | — |
| Cascade Valley Hospital | $292 – $4,679 | $2,750 – $3,743 | $3,438 – $4,679 |
| Deaconess Medical Center | $229 – $567 | — | — |
| EvergreenHealth Medical Center | $9.11 – $363 | $102 | $128 |
| Harborview Medical Center | $231 – $307 | — | — |
| Highline Medical Center | $6.17 – $1,775 | $4.38 – $602 | $14.33 – $1,972 |
| Island Hospital | $193 – $267 | — | — |
| Kadlec Regional Medical Center | $12.69 – $390 | — | — |
| Legacy Salmon Creek Medical Center | $3.92 – $277 | — | — |
| Mary Bridge Children's Hospital | $1,000 | — | — |
| MultiCare Auburn Medical Center | $239 – $597 | — | — |
| MultiCare Covington Medical Center | $239 – $597 | — | — |
| MultiCare Good Samaritan Hospital | $240 – $597 | — | — |
| MultiCare Valley Hospital | $229 – $566 | — | — |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $19.01 – $380 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $11.04 – $460 | — | — |
| Providence Centralia Hospital | $30.66 – $539 | — | — |
| Providence Holy Family Hospital | $11.04 – $508 | — | — |
| Providence Regional Medical Center Everett | $11.04 – $440 | — | — |
| Providence St Mary Medical Center | $48.44 – $408 | — | — |
| Providence St Peter Hospital | $16.82 – $559 | — | — |
| Skagit Valley Hospital | $496 – $4,445 | $2,750 – $3,743 | $3,438 – $4,679 |
| St Anthony Hospital | $10.32 – $1,479 | $4.36 – $600 | $14.33 – $1,972 |
| St Clare Hospital | $10.32 – $1,479 | $4.14 – $568 | $14.33 – $1,972 |
| St Elizabeth Hospital | $4.78 – $1,775 | $5.07 – $697 | $14.33 – $1,972 |
| St Francis Community Hospital | $10.32 – $1,479 | $4.50 – $619 | $14.33 – $1,972 |
| St Joseph Medical Center | $10.32 – $1,479 | $4.75 – $653 | $14.33 – $1,972 |
| St Michael Medical Center | $9.75 – $1,775 | $6.33 – $870 | $14.33 – $1,972 |
| Swedish Edmonds Hospital | $11.04 – $510 | — | — |
| Swedish Issaquah | $11.04 – $613 | — | — |
| Swedish Medical Center | $11.04 – $611 | — | — |
| Swedish Medical Center / Cherry Hill | $11.04 – $611 | — | — |
| Tacoma General Allenmore Hospital | $240 – $597 | — | — |
| University of Washington Medical Ctr | $231 – $452 | — | — |
| Wellfound Behavioral Health Hospital | $367 | — | — |
| WhidbeyHealth Medical Center | — | $1.00 | $1.00 |
| 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