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
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | — | — |
| Cascade Valley Hospital | $3,450 – $4,725 | $2,750 – $3,743 | $3,438 – $4,679 |
| Deaconess Medical Center | — | — | — |
| EvergreenHealth Medical Center | — | $102 | $128 |
| Harborview Medical Center | — | — | — |
| Highline Medical Center | — | $4.38 – $602 | $14.33 – $1,972 |
| Island Hospital | $149 | — | — |
| Kadlec Regional Medical Center | — | — | — |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | — | — |
| MultiCare Auburn Medical Center | — | — | — |
| MultiCare Covington Medical Center | — | — | — |
| MultiCare Good Samaritan Hospital | — | — | — |
| MultiCare Valley Hospital | — | — | — |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | — | — |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | — | — |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Mary Medical Center | — | — | — |
| Providence St Peter Hospital | — | — | — |
| Skagit Valley Hospital | — | $2,750 – $3,743 | $3,438 – $4,679 |
| St Anthony Hospital | — | $4.36 – $600 | $14.33 – $1,972 |
| St Clare Hospital | — | $4.14 – $568 | $14.33 – $1,972 |
| St Elizabeth Hospital | $2.44 – $408 | $5.07 – $697 | $14.33 – $1,972 |
| St Francis Community Hospital | — | $4.50 – $619 | $14.33 – $1,972 |
| St Joseph Medical Center | — | $4.75 – $653 | $14.33 – $1,972 |
| St Michael Medical Center | — | $6.33 – $870 | $14.33 – $1,972 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | — | — |
| Swedish Medical Center | — | — | — |
| Swedish Medical Center / Cherry Hill | — | — | — |
| Tacoma General Allenmore Hospital | — | — | — |
| University of Washington Medical Ctr | — | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| WhidbeyHealth Medical Center | — | $1.00 | $1.00 |
| Yakima Valley Memorial | — | — | — |
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