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HCPCS Q4168

Amnioband, 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

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$2,946 – $10,8972 plans$1,614 – $5,128$4,036 – $12,820
Deaconess Medical CenterSpokaneFile dated 2026-08-27$1,499 – $9,3595 plans$1,614 – $5,128$4,036 – $12,820
Highline Medical CenterBurienFile dated 2026-02-28$3,809 – $15,3395 plans$2,705 – $5,204$8,859 – $17,044
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$2,607 – $10,4356 plans$1,614 – $5,128$4,036 – $12,820
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$2,946 – $9,3592 plans$1,614 – $5,128$4,036 – $12,820
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$2,946 – $9,3592 plans$1,614 – $5,128$4,036 – $12,820
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$2,946 – $9,3592 plans$1,614 – $5,128$4,036 – $12,820
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$1,499 – $9,2305 plans$1,614 – $5,128$4,036 – $12,820
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$31.71 – $33.763 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$19.241 plan——
Providence Holy Family HospitalSpokaneFile dated 2026-04-01$19.241 plan——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$19.241 plan——
St Anthony HospitalGig HarborFile dated 2026-02-28$4,429 – $12,7833 plans$2,694 – $5,184$8,859 – $17,044
St Clare HospitalLakewoodFile dated 2026-02-28$4,429 – $12,7833 plans$2,554 – $4,913$8,859 – $17,044
St Elizabeth HospitalEnumclawFile dated 2026-02-28$2,950 – $15,3399 plans$3,130 – $6,023$8,859 – $17,044
St Francis Community HospitalFederal WayFile dated 2026-02-28$4,429 – $12,7833 plans$2,780 – $5,349$8,859 – $17,044
St Joseph Medical CenterTacomaFile dated 2026-02-28$4,429 – $12,7833 plans$2,934 – $5,645$8,859 – $17,044
St Michael Medical CenterSilverdaleFile dated 2026-02-28$34.51 – $15,33910 plans$3,910 – $7,522$8,859 – $17,044
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$19.241 plan——
Swedish IssaquahIssaquahFile dated 2026-04-01$19.241 plan——
Swedish Medical CenterSeattleFile dated 2026-04-01$19.241 plan——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$19.241 plan——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$2,946 – $9,3592 plans$1,614 – $5,128$4,036 – $12,820

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.