HCPCS Q4289
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
HC GRAFT SFT TIS 4X4CM REVOSHIELD AMNIO BRR ALGRF 2 (QTY 16)
Prices here combine facility and professional fees. See them separately →Experimental
Low
$0
Average
$5.8k
Median
$7.5k
High
$8.7k
Showing only prices reported under the percent of billed charges methodology. Choose another in the filter below to change the chart. 11 hospitals; the 90th percentile is 28.9× 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.
Click a bar to filter the hospitals table to that price range.
Filter by billing methodology
Reflects a negotiated percentage of total billed charges.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | MultiCare Auburn Medical Center Auburn, WA | $7.0k | $7.5k | $1.1k | 15% | — | $5.5k – $8.8k |
| 2 | MultiCare Capital Medical Center Olympia, WA | $8.4k | $8.7k | $1.2k | 14% | — | $6.8k – $10.3k |
| 3 | Tacoma General Allenmore Hospital Tacoma, WA | $7.0k | $7.5k | $1.1k | 15% | — | $5.5k – $8.8k |
| 4 | Hca Florida North Florida Hospital NEWBERRY, FL | $0 | $0 | $0 | 72% | — | $0 – $1 |
| 5 | MultiCare Deaconess Hospital Spokane, WA | $6.8k | $6.8k | $1.7k | 25% | — | $3.5k – $8.8k |
| 6 | Mary Bridge Children's Hospital Tacoma, WA | $7.7k | $8.1k | $1.2k | 14% | — | $6.1k – $9.8k |
| 7 | Bexar County Hospital District San Antonio, TX | $2.6k | $2.9k | $1.6k | 54% | — | $1.3k – $13.1k |
| 8 | Baxter County Regional Hospital, Inc. Home, AR | $273 | $281 | $70 | 25% | — | $148 – $390 |
| 9 | Good Samaritan Hospital Puyallup, WA | $7.0k | $7.5k | $1.1k | 15% | — | $5.5k – $8.8k |
| 10 | MultiCare Covington Medical Center Covington, WA | $7.0k | $7.5k | $1.1k | 15% | — | $5.5k – $8.8k |
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