HCPCS Q4151

Amnioband or guardian, per square centimeter (add-on, list separately in addition to primary procedure)

Current codeSkin Substitute Products36 hospitals with prices

Description from CMS's HCPCS Level II code file.

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.

Prices for HCPCS Q4151 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27	—	$422 – $12,880	$1,055 – $32,200
Deaconess Medical CenterSpokaneFile dated 2026-08-27	—	$422 – $12,880	$1,055 – $32,200
Harborview Medical CenterSeattleFile dated 2026-04-01	—	$10,206	$14,580
Highline Medical CenterBurienFile dated 2026-02-28	—	$1,170 – $19,508	$3,833 – $63,887
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01	—	$265 – $10,544	$379 – $15,063
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27	—	$422 – $12,880	$1,055 – $32,200
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27	—	$422 – $12,880	$1,055 – $32,200
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27	—	$422 – $12,880	$1,055 – $32,200
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27	—	$422 – $12,880	$1,055 – $32,200
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27	—	$422 – $12,880	$1,055 – $32,200
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01	—	$372 – $13,766	$532 – $19,666
Providence Centralia HospitalCentraliaFile dated 2026-04-01	—	$394 – $15,350	$758 – $29,520
Providence Holy Family HospitalSpokaneFile dated 2026-04-01	—	$372 – $13,766	$532 – $19,666
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01	—	$352 – $13,192	$504 – $18,846
Providence Regional Medical Center EverettEverettFile dated 2026-04-01	—	$436 – $18,375	$839 – $35,337
Providence St Joseph HospitalChewelahFile dated 2026-04-01	—	$352 – $13,192	$504 – $18,846
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01	—	$307 – $12,393	$438 – $17,704
Providence St Peter HospitalOlympiaFile dated 2026-04-01	—	$394 – $15,350	$758 – $29,520
St Anthony HospitalGig HarborFile dated 2026-02-28	—	$1,166 – $19,431	$3,833 – $63,887
St Clare HospitalLakewoodFile dated 2026-02-28	—	$1,105 – $18,415	$3,833 – $63,887
St Elizabeth HospitalEnumclawFile dated 2026-02-28	$1,073 – $21,1915 plans	$1,355 – $22,575	$3,833 – $63,887
St Francis Community HospitalFederal WayFile dated 2026-02-28	—	$1,203 – $20,049	$3,833 – $63,887
St Joseph Medical CenterTacomaFile dated 2026-02-28	—	$1,270 – $21,159	$3,833 – $63,887
St Michael Medical CenterSilverdaleFile dated 2026-02-28	—	$1,692 – $28,196	$3,833 – $63,887
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01	—	$270 – $13,843	$563 – $28,840
Swedish IssaquahIssaquahFile dated 2026-04-01	—	$270 – $13,843	$563 – $28,840
Swedish Medical CenterSeattleFile dated 2026-04-01	—	$270 – $13,843	$563 – $28,840
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01	—	$270 – $13,843	$563 – $28,840
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27	—	$422 – $12,880	$1,055 – $32,200
University of Washington Medical CtrSeattleFile dated 2026-04-01	—	$9,072	$12,960

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

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 6002)
Surgery center payment (national): $127