HCPCS Q4195
Puraply, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products30 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 – $10,574 | $2,312 – $4,976 | $5,780 – $12,440 |
| Deaconess Medical Center | $229 – $9,081 | $2,312 – $4,976 | $5,780 – $12,440 |
| Harborview Medical Center | $231 – $307 | — | — |
| Island Hospital | $193 – $267 | — | — |
| Kadlec Regional Medical Center | $128 – $391 | $2,066 – $8,215 | $2,952 – $11,736 |
| Legacy Salmon Creek Medical Center | $131 – $277 | — | — |
| Mary Bridge Children's Hospital | $1,000 – $10,126 | $2,312 – $4,976 | $5,780 – $12,440 |
| MultiCare Auburn Medical Center | $239 – $9,081 | $2,312 – $4,976 | $5,780 – $12,440 |
| MultiCare Covington Medical Center | $239 – $9,081 | $2,312 – $4,976 | $5,780 – $12,440 |
| MultiCare Good Samaritan Hospital | $240 – $9,081 | $2,312 – $4,976 | $5,780 – $12,440 |
| MultiCare Valley Hospital | $229 – $8,957 | $2,312 – $4,976 | $5,780 – $12,440 |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $159 – $380 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $182 – $460 | $2,106 – $10,726 | $3,009 – $15,322 |
| Providence Centralia Hospital | $244 – $643 | $3,440 – $11,569 | $6,615 – $22,248 |
| Providence Holy Family Hospital | $166 – $508 | $2,106 – $10,726 | $3,009 – $15,322 |
| Providence Mount Carmel Hospital | — | $2,010 – $10,279 | $2,871 – $14,684 |
| Providence Regional Medical Center Everett | $170 – $440 | $3,594 – $14,317 | $6,912 – $27,532 |
| Providence St Joseph Hospital | — | $2,010 – $10,279 | $2,871 – $14,684 |
| Providence St Mary Medical Center | — | $2,073 – $9,656 | $2,961 – $13,794 |
| Providence St Peter Hospital | $122 – $559 | $3,440 – $11,569 | $6,615 – $22,248 |
| Swedish Edmonds Hospital | $182 – $510 | $2,182 – $10,786 | $4,545 – $22,470 |
| Swedish Issaquah | $182 – $613 | $247 – $10,786 | $514 – $22,470 |
| Swedish Medical Center | $182 – $611 | $247 – $10,786 | $514 – $22,470 |
| Swedish Medical Center / Cherry Hill | $182 – $611 | $247 – $10,786 | $514 – $22,470 |
| Tacoma General Allenmore Hospital | $240 – $9,081 | $2,312 – $4,976 | $5,780 – $12,440 |
| University of Washington Medical Ctr | $198 – $452 | — | — |
| Wellfound Behavioral Health Hospital | $367 | — | — |
| WhidbeyHealth Medical Center | — | $475 – $982 | $475 – $982 |
| 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