GRAFT TISSUE HUMAN AMNIOTIC MEMBRANE MIS ROOM AMNIOEFFECT LS5230 2X3CM - as described in hospitals' own price files.
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|
| Grandview Medical Center | Birmingham, AL | $66.90 | $69.70 | $446 | $10.50 - $446 |
| Mat-Su Regional Medical Center | Palmer, AK | $225 | $638 | $750 | $75.79 - $2,863 |
| Providence Cedars Sinai Tarzana Medical Center | Tarzana, CA | $732 | - | $2,091 | - |
| Saint John'S Health Center | Santa Monica, CA | $732 | - | $2,091 | - |
| Providence Little Co Of Mary Med Ctr San Pedro | San Pedro, CA | $732 | - | $2,091 | - |
| Providence Holy Cross Medical Center | Mission Hills, CA | $732 | - | $2,091 | - |
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | $732 | - | $2,091 | - |
| Providence Saint Joseph Medical Ctr | Burbank, CA | $732 | - | $2,091 | - |
| Providence Hood River Memorial Hospital | Hood River, OR | $902 | - | $1,203 | - |
| Providence Newberg Medical Center | Newberg, OR | $902 | - | $1,203 | - |
| Providence Seaside Hospital | Seaside, OR | $902 | - | $1,203 | - |
| Providence Medford Medical Center | Medford, OR | $902 | - | $1,203 | - |
| Providence Milwaukie Hospital | Milwaukie, OR | $902 | - | $1,203 | - |
| Providence St. Vincent Medical Center | Portland, OR | $902 | - | $1,203 | - |
| Providence Portland Medical Center | Portland, OR | $902 | - | $1,203 | - |
| Providence Willamette Falls Medical Center | Oregon City, OR | $902 | - | $1,203 | - |
| Healdsburg Hospital | Healdsburg, CA | $958 | - | $1,877 | - |
| St. Patrick Hospital | Missoula, MT | $973 | - | $1,216 | - |
| Providence Mount Carmel Hospital | Colville, WA | $1,027 | - | $1,468 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $1,027 | - | $1,468 | - |
| Kadlec Regional Medical Center | Richland, WA | $1,072 | - | $1,532 | - |
| Providence Holy Family Hospital | Spokane, WA | $1,078 | - | $1,541 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $1,098 | - | $2,287 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $1,098 | - | $2,287 | - |
| Swedish Issaquah | Issaquah, WA | $1,098 | - | $2,287 | - |
| Providence St. Mary Medical Center | Walla Walla, WA | $1,120 | - | $1,600 | - |
| St. Mary Medical Center | Long Beach, CA | $1,292 | - | $2,692 | - |
| Providence Queen Of The Valley Medical Center | Napa, CA | $1,388 | - | $2,722 | - |
| Covenant Hospital Levelland | Levelland, TX | $1,391 | - | $3,311 | - |
| Covenant Hospital Plainview | Plainview, TX | $1,391 | - | $3,311 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $1,391 | - | $3,311 | - |
| Covenant Medical Center | Lubbock, TX | $1,391 | - | $3,311 | - |
| Petaluma Valley Hospital | Petaluma, CA | $1,393 | - | $2,731 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $1,393 | - | $2,731 | - |
| Grace Surgical Hospital | Lubbock, TX | $1,405 | - | $3,345 | - |
| Providence St. Jude Medical Center | Fullerton, CA | $1,426 | - | $2,970 | - |
| Providence Valdez Medical Center | Valdez, AK | $1,514 | - | $1,941 | - |
| Providence Redwood Memorial Hospital | Fortuna, CA | $1,523 | - | $2,987 | - |
| Providence St. Joseph Hospital | Eureka, CA | $1,526 | - | $3,179 | - |
| Providence Centralia Hospital | Centralia, WA | $1,660 | - | $3,192 | - |
| Providence St. Peter Hospital | Olympia, WA | $1,660 | - | $3,192 | - |
| Providence Regional Medical Center Everett | Everett, WA | $1,811 | - | $3,482 | - |
| Providence Alaska Medical Center | Anchorage, AK | $2,886 | - | $3,699 | - |
| Providence Kodiak Island Medical Ctr | Kodiak, AK | $4,008 | - | $5,139 | - |
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.