HCPCS Q4196
Puraply am, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products43 hospitals with prices
What Washington hospitals publish for this code
Other government program: TRICARE, VA, Indian Health Service, workers' compensation, or another public program.
| Hospital | Other government program rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $1,940 – $10,509 | $4,850 – $26,272 |
| Cascade Valley Hospital | — | $446 – $4,147 | $558 – $5,184 |
| Deaconess Medical Center | — | $1,940 – $10,509 | $4,850 – $26,272 |
| EvergreenHealth Medical Center | — | $256 | $320 |
| EvergreenHealth Monroe | — | $356 | $445 |
| Harborview Medical Center | — | $2,008 – $41,678 | $2,868 – $59,540 |
| Highline Medical Center | — | $238 – $12,056 | $781 – $39,482 |
| Kadlec Regional Medical Center | — | $170 – $7,577 | $243 – $10,824 |
| Mary Bridge Children's Hospital | — | $1,940 – $10,509 | $4,850 – $26,272 |
| MultiCare Auburn Medical Center | — | $1,940 – $10,509 | $4,850 – $26,272 |
| MultiCare Covington Medical Center | — | $1,940 – $10,509 | $4,850 – $26,272 |
| MultiCare Good Samaritan Hospital | — | $1,940 – $10,509 | $4,850 – $26,272 |
| MultiCare Valley Hospital | — | $1,940 – $10,509 | $4,850 – $26,272 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $1,137 – $9,892 | $1,625 – $14,132 |
| Providence Centralia Hospital | — | $1,750 – $10,670 | $3,366 – $20,520 |
| Providence Holy Family Hospital | — | $1,137 – $9,892 | $1,625 – $14,132 |
| Providence Mount Carmel Hospital | — | $1,084 – $9,480 | $1,548 – $13,543 |
| Providence Regional Medical Center Everett | — | $1,909 – $13,205 | $3,672 – $25,394 |
| Providence St Joseph Hospital | — | $1,084 – $9,480 | $1,548 – $13,543 |
| Providence St Mary Medical Center | — | $1,181 – $8,906 | $1,688 – $12,722 |
| Providence St Peter Hospital | — | $1,750 – $10,670 | $3,366 – $20,520 |
| Skagit Valley Hospital | — | $446 – $4,147 | $558 – $5,184 |
| St Anthony Hospital | — | $237 – $12,008 | $781 – $39,482 |
| St Clare Hospital | — | $225 – $11,380 | $781 – $39,482 |
| St Elizabeth Hospital | — | $276 – $13,951 | $781 – $39,482 |
| St Francis Community Hospital | — | $245 – $12,390 | $781 – $39,482 |
| St Joseph Medical Center | — | $259 – $13,076 | $781 – $39,482 |
| St Michael Medical Center | — | $345 – $17,425 | $781 – $39,482 |
| Swedish Edmonds Hospital | — | $1,158 – $9,948 | $2,412 – $20,725 |
| Swedish Issaquah | — | $219 – $9,948 | $456 – $20,725 |
| Swedish Medical Center | — | $219 – $9,948 | $456 – $20,725 |
| Swedish Medical Center / Cherry Hill | — | $219 – $9,948 | $456 – $20,725 |
| Tacoma General Allenmore Hospital | — | $1,940 – $10,509 | $4,850 – $26,272 |
| University of Washington Medical Ctr | — | $1,752 – $37,345 | $2,503 – $53,350 |
| Virginia Mason Medical Center | — | $60.18 – $574 | $118 – $1,125 |
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