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
CE-Allograft Prolayer 4x4cm; 2.0- 3.3mm Thick
San Diego, CA
See all hospitals reporting HCPCS Q4100 →Price type
Sharp Memorial Hospital’s median price of $2.9k is 63% above the median hospital's median price ($1.8k), higher than 66% of the 962 hospitals reporting HCPCS Q4100. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 82 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Molina molina - exchange fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Optum optum health - commercial fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 3 | UnitedHealthcare united healthcare - hmo fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 4 | UnitedHealthcare united healthcare - medicare fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 5 | MultiPlan multiplan fee schedule · outpatient | $1 | $1 | $0 | 6% | — | $1 – $1 |
| 6 | Molina molina - cal medi-connect fee schedule · outpatient | $1 | $1 | $0 | 5% | — | $1 – $1 |
| 7 | Blue Cross Blue Shield blue shield - promise fee schedule · outpatient | $1 | $1 | $0 | 7% | — | $1 – $1 |
| 8 | Cigna cigna - hmo fee schedule · outpatient | $1 | $1 | $0 | 7% | — | $1 – $1 |
| 9 | Medicaid medi-cal fee schedule · outpatient | $1 | $1 | $0 | 6% | — | $1 – $1 |
| 10 | Cigna cigna - ppo fee schedule · outpatient | $1 | $1 | $0 | 6% | — | $1 – $1 |
| 11 | Medicare medicare fee schedule · outpatient | $1 | $1 | $0 | 11% | — | $1 – $1 |
| 12 | Optum optum health - medicare fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 13 | UnitedHealthcare united healthcare - ppo fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 14 | Aetna first health - direct fee schedule · outpatient | $1 | $1 | $0 | 2% | — | $1 – $1 |
| 15 | Blue Cross Blue Shield blue cross - hmo fee schedule · outpatient | $1 | $1 | $0 | 13% | — | $1 – $1 |
| 16 | Kaiser kaiser - hmo fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 17 | Molina molina medi-cal fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 18 | Blue Cross Blue Shield blue cross - standard fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 19 | Aetna aetna - ppo case rate · outpatient | $725 | $725 | — | — | — | $725 – $725 |
| 20 | Medicare medicare case rate · inpatient | $725 | $725 | — | — | — | $725 – $725 |
| 21 | UnitedHealthcare united healthcare - medicare case rate · inpatient | $725 | $725 | — | — | — | $725 – $725 |
| 22 | Blue Cross Blue Shield blue shield - ppo percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.9k | $1.8k | 98% | — | $177 – $5.5k |
| 23 | Aetna first health - direct percent of total billed charges · inpatientfrom % of charges | $1.2k | $2.2k | $2.5k | 114% | — | $17 – $7.5k |
| 24 | UnitedHealthcare united healthcare - ppo percent of total billed charges · inpatientfrom % of charges | $2.2k | $2.4k | $1.7k | 74% | — | $138 – $5.0k |
| 25 | Blue Cross Blue Shield blue cross - hmo percent of total billed charges · outpatientfrom % of charges | $1.7k | $2.5k | $2.6k | 103% | — | $17 – $9.1k |
Last updated: Apr 1, 2026
See Amniotic membrane allograft, 9 x 20 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.