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
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 | — | $2,312 – $4,976 | $5,780 – $12,440 |
| Deaconess Medical Center | — | $2,312 – $4,976 | $5,780 – $12,440 |
| Harborview Medical Center | — | — | — |
| Island Hospital | $149 | — | — |
| Kadlec Regional Medical Center | — | $2,066 – $8,215 | $2,952 – $11,736 |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | $2,312 – $4,976 | $5,780 – $12,440 |
| MultiCare Auburn Medical Center | — | $2,312 – $4,976 | $5,780 – $12,440 |
| MultiCare Covington Medical Center | — | $2,312 – $4,976 | $5,780 – $12,440 |
| MultiCare Good Samaritan Hospital | — | $2,312 – $4,976 | $5,780 – $12,440 |
| MultiCare Valley Hospital | — | $2,312 – $4,976 | $5,780 – $12,440 |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $2,106 – $10,726 | $3,009 – $15,322 |
| Providence Centralia Hospital | — | $3,440 – $11,569 | $6,615 – $22,248 |
| Providence Holy Family Hospital | — | $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 | — | $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 | — | $3,440 – $11,569 | $6,615 – $22,248 |
| Swedish Edmonds Hospital | — | $2,182 – $10,786 | $4,545 – $22,470 |
| Swedish Issaquah | — | $247 – $10,786 | $514 – $22,470 |
| Swedish Medical Center | — | $247 – $10,786 | $514 – $22,470 |
| Swedish Medical Center / Cherry Hill | — | $247 – $10,786 | $514 – $22,470 |
| Tacoma General Allenmore Hospital | — | $2,312 – $4,976 | $5,780 – $12,440 |
| University of Washington Medical Ctr | — | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| WhidbeyHealth Medical Center | — | $475 – $982 | $475 – $982 |
| 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