Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
MEMBRANE PLACENTA TISS BIODFENCE G3 4X4CM-16SQCM-Q4116-COST PER SQ CM
Low
$180
Average
$4.0k
Median
$1.1k
High
$35.8k
Each hospital's average First Health rate, under the methodology and billing class chosen below.
81 hospitals; the 90th percentile is 30.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
88 hospital rates
iThe hospitals that file a First Health rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 3 | BRFHH MONROE, LLC Monroe, LA other · inpatient | 1 | $3.1k | $3.8k | $1.9k | 50% | — | $2.2k – $7.4k |
| 4 | BRFHH MONROE, LLC Monroe, LA other · outpatient | 1 | $3.1k | $3.8k | $1.9k | 50% | — | $2.2k – $7.4k |
| 5 | Broaddus Hospital Association Inc Philippi, WV professional · fee schedule · both | 1 | $180 | $180 | — | — | — | $180 – $180 |
| 6 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $161 | $206 | $89 | 43% | — | $126 – $330 |
| 7 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $161 | $206 | $89 | 43% | — | $126 – $330 |
| 8 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $342 | $436 | $189 | 43% | — | $266 – $699 |
| 9 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $415 | $529 | $229 | 43% | — | $323 – $848 |
| 10 | Davis Medical Center Elkins, WV professional · fee schedule · both | 1 | $180 | $180 | — | — | — | $180 – $180 |
| 11 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $305 | $389 | $168 | 43% | — | $238 – $624 |
| 12 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · inpatient | 1 | $2.9k | $3.5k | $1.8k | 50% | — | $2.1k – $6.8k |
| 13 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $2.9k | $3.5k | $1.8k | 50% | — | $2.1k – $6.8k |
| 14 | Greenfield Area Medical Center Greenfield, OH facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 15 | HOSPITAL SERVICE DISTRICT NO. 1 OF THE PARISH OF ST. CHARLES, STATE OF LOUISIANA LULING, LA percent of total billed charges · outpatientfrom % of charges | 1 | $4.5k | $5.4k | $2.7k | 50% | — | $3.2k – $10.6k |
| 16 | HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST. BERNARD, STATE OF LOUISIANA Chalmette, LA percent of total billed charges · outpatientfrom % of charges | 1 | $3.1k | $3.8k | $1.9k | 50% | — | $2.2k – $7.4k |
| 17 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · inpatientfrom % of charges | 1 | $246 | $246 | — | — | — | $246 – $246 |
| 18 | HSA PGH LLC Hialeah, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $246 | $246 | — | — | — | $246 – $246 |
| 19 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · percent of total billed charges · bothfrom % of charges | 2 | $302 | $364 | $175 | 48% | — | $180 – $695 |
| 20 | LOS ROBLES HOSPITAL AND MEDICAL CENTER THOUSAND OAKS, CA percent of total billed charges · outpatientfrom % of charges | 1 | $7.5k | $7.5k | — | — | — | $7.5k – $7.5k |
| 21 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 1 | $7.5k | $7.5k | $241 | 3% | — | $7.3k – $7.8k |
| 22 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $408 | $519 | $225 | 43% | — | $317 – $832 |
| 23 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $449 | $572 | $247 | 43% | — | $349 – $917 |
| 24 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $393 | $456 | $155 | 34% | — | $306 – $669 |
| 25 | Mercy Health Services-Iowa Corp. Mason City, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $244 | $311 | $135 | 43% | — | $190 – $499 |
← Payers reporting HCPCS Q4140 · Snapshot 20261111T120946Z-9134e7f7