DRSG FOAM OPTFM AG 4X4IN - as described in hospitals' own price files.
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|
| Grace Surgical Hospital | Lubbock, TX | $2.09 | - | $4.98 | - |
| Providence Cedars Sinai Tarzana Medical Center | Tarzana, CA | $8.80 | - | $25.14 | - |
| Saint John'S Health Center | Santa Monica, CA | $8.80 | - | $25.14 | - |
| Providence Little Co Of Mary Med Ctr San Pedro | San Pedro, CA | $8.80 | - | $25.14 | - |
| Providence Holy Cross Medical Center | Mission Hills, CA | $8.80 | - | $25.14 | - |
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | $8.80 | - | $25.14 | - |
| Providence Saint Joseph Medical Ctr | Burbank, CA | $8.80 | - | $25.14 | - |
| Providence Hood River Memorial Hospital | Hood River, OR | $11.76 | - | $15.68 | - |
| Providence Newberg Medical Center | Newberg, OR | $11.76 | - | $15.68 | - |
| Providence Seaside Hospital | Seaside, OR | $11.76 | - | $15.68 | - |
| Providence Medford Medical Center | Medford, OR | $11.76 | - | $15.68 | - |
| Providence Milwaukie Hospital | Milwaukie, OR | $11.76 | - | $15.68 | - |
| Providence St. Vincent Medical Center | Portland, OR | $11.76 | - | $15.68 | - |
| Providence Portland Medical Center | Portland, OR | $11.76 | - | $15.68 | - |
| Providence Willamette Falls Medical Center | Oregon City, OR | $11.76 | - | $15.68 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $13.62 | - | $28.38 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $13.62 | - | $28.38 | - |
| Swedish Issaquah | Issaquah, WA | $13.62 | - | $28.38 | - |
| St. Mary Medical Center | Long Beach, CA | $16.01 | - | $33.36 | - |
| Healdsburg Hospital | Healdsburg, CA | $16.25 | - | $31.87 | - |
| Kadlec Regional Medical Center | Richland, WA | $16.38 | - | $23.40 | - |
| Providence Queen Of The Valley Medical Center | Napa, CA | $16.71 | - | $32.76 | - |
| St. Patrick Hospital | Missoula, MT | $17.13 | - | $21.41 | - |
| Providence St. Jude Medical Center | Fullerton, CA | $17.69 | - | $36.85 | - |
| Providence St. Joseph Hospital | Eureka, CA | $19.12 | - | $39.84 | - |
| Providence Centralia Hospital | Centralia, WA | $20.72 | - | $39.84 | - |
| Providence St. Peter Hospital | Olympia, WA | $20.72 | - | $39.84 | - |
| Providence St. Mary Medical Center | Walla Walla, WA | $20.92 | - | $29.88 | - |
| Providence Valdez Medical Center | Valdez, AK | $21.59 | - | $27.68 | - |
| Providence Redwood Memorial Hospital | Fortuna, CA | $21.59 | - | $42.33 | - |
| Providence Regional Medical Center Everett | Everett, WA | $22.01 | - | $42.33 | - |
| Providence Kodiak Island Medical Ctr | Kodiak, AK | $22.53 | - | $28.88 | - |
| Petaluma Valley Hospital | Petaluma, CA | $25.40 | - | $49.80 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $25.40 | - | $49.80 | - |
| Covenant Hospital Levelland | Levelland, TX | $27.19 | - | $64.74 | - |
| Covenant Hospital Plainview | Plainview, TX | $27.19 | - | $64.74 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $27.19 | - | $64.74 | - |
| Covenant Medical Center | Lubbock, TX | $27.19 | - | $64.74 | - |
| Providence Mount Carmel Hospital | Colville, WA | $33.12 | - | $47.31 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $33.12 | - | $47.31 | - |
| Providence Holy Family Hospital | Spokane, WA | $35.19 | - | $50.27 | - |
| Providence Alaska Medical Center | Anchorage, AK | $36.90 | - | $47.31 | - |
Prices are from each hospital's own machine-readable price file. Cash price is the published discounted cash price; typical insurance price is the median of the per-plan negotiated rates in the file; list price is the gross charge.