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
$116
Average
$323
Median
$175
High
$1.2k
Each hospital's average Regence rate, under the methodology and billing class chosen below.
49 hospitals; the 90th percentile is 4.1× 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.
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49 hospital rates
iThe hospitals that file a Regence 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 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 2 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $345 | $440 | $190 | 43% | — | $269 – $705 |
| 3 | GRITMAN MEDICAL CENTER INC Moscow, ID professional · fee schedule · outpatient | 1 | $153 | $153 | — | — | — | $153 – $153 |
| 4 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 5 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $448 | $570 | $247 | 43% | — | $348 – $915 |
| 6 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 7 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $373 | $475 | $206 | 43% | — | $290 – $762 |
| 8 | IHC Health Services Inc., DBA Intermountain Health Bear River Valley Hospital Tremonton, UT facility · fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 9 | IHC Health Services Inc., DBA Intermountain Health Intermountain Medical Center Murray, UT facility · fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 10 | IHC Health Services Inc., DBA Intermountain Health Layton Hospital Layton, UT facility · case rate · outpatient | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 11 | IHC Health Services Inc., DBA Intermountain Health Orem Community Hospital Orem, UT facility · fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 12 | IHC Health Services Inc., DBA Intermountain Health Park City Hospital Park City, UT facility · fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 13 | IHC Health Services Inc., DBA Intermountain Health Riverton Hospital Riverton, UT facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 14 | IHC Health Services Inc., DBA Intermountain Health St George Regional Hospital St. George, UT facility · fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 15 | Johnson Memorial Hospital Stafford Springs, CT facility · percent of total billed charges · bothfrom % of charges | 1 | $331 | $422 | $183 | 43% | — | $258 – $676 |
| 16 | Mary Bridge Children's Hospital Tacoma, WA fee schedule · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 17 | Mercy Fitzgerald Hospital Darby, PA facility · percent of total billed charges · bothfrom % of charges | 1 | $911 | $1.2k | $502 | 43% | — | $708 – $1.9k |
| 18 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $242 | $309 | $134 | 43% | — | $188 – $495 |
| 19 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $425 | $541 | $234 | 43% | — | $330 – $867 |
| 20 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $240 | $279 | $95 | 34% | — | $187 – $409 |
| 21 | Mishawaka Medical Center Mishawaka, IN facility · percent of total billed charges · bothfrom % of charges | 1 | $239 | $305 | $132 | 43% | — | $186 – $489 |
| 22 | Mount Carmel East Reynoldsburg, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $395 | $503 | $218 | 43% | — | $307 – $806 |
| 23 | Mount Carmel Grove City Grove City, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $395 | $503 | $218 | 43% | — | $307 – $806 |
| 24 | Mount Carmel New Albany Surgical Hospital New Albany, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $395 | $503 | $218 | 43% | — | $307 – $806 |
| 25 | Mount Carmel St Ann's Lewis Center, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $395 | $503 | $218 | 43% | — | $307 – $806 |
← Payers reporting HCPCS Q4140 · Snapshot 20261111T120946Z-9134e7f7