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HCPCS Q4155

Neoxflo or clarixflo, 1 mg

Current codeSkin Substitute Products23 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Highline Medical CenterBurienFile dated 2026-02-28—$650 – $2,601$2,130 – $8,518
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$1,834 – $2,727$2,620 – $3,896
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01———
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$1,849 – $2,951$2,641 – $4,216
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$2,982 – $4,843$5,735 – $9,314
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$1,849 – $2,951$2,641 – $4,216
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$1,763 – $2,817$2,519 – $4,025
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$3,160 – $4,951$6,076 – $9,520
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$1,763 – $2,817$2,519 – $4,025
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$1,845 – $2,799$2,635 – $3,999
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$1,517 – $4,843$2,917 – $9,314
St Anthony HospitalGig HarborFile dated 2026-02-28—$648 – $2,591$2,130 – $8,518
St Clare HospitalLakewoodFile dated 2026-02-28—$614 – $2,455$2,130 – $8,518
St Elizabeth HospitalEnumclawFile dated 2026-02-28$383 – $1,87412 plans$753 – $3,010$2,130 – $8,518
St Francis Community HospitalFederal WayFile dated 2026-02-28—$668 – $2,673$2,130 – $8,518
St Joseph Medical CenterTacomaFile dated 2026-02-28—$705 – $2,821$2,130 – $8,518
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$940 – $3,760$2,130 – $8,518
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$1,916 – $3,003$3,991 – $6,257
Swedish IssaquahIssaquahFile dated 2026-04-01—$1,916 – $3,003$3,991 – $6,257
Swedish Medical CenterSeattleFile dated 2026-04-01—$1,916 – $3,003$3,991 – $6,257
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$1,916 – $3,003$3,991 – $6,257
Yakima Valley MemorialYakimaFile dated 2026-08-27———

Lowest and highest amounts each hospital lists for this code as an outpatient, 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

CMS publishes no national amount for this code.