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
$1
Average
$142
Median
$152
High
$261
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4 hospital rates
iThe hospitals that file a Medicaid 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 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 2 | Ohio State University Hospitals Columbus, OH fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 3 | Saint Alphonsus Medical Center - Baker City Baker City, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $205 | $261 | $113 | 43% | — | $159 – $418 |
| 4 | Saint Alphonsus Medical Center - Ontario Ontario, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $140 | $178 | $77 | 43% | — | $109 – $285 |
← Payers reporting HCPCS Q4140 · Snapshot 20261111T120946Z-9134e7f7