GRAFT TISSUE AMNIOTIC MEMBRANE MULTIPLE SITES AFFINITY FRESH 2.5X2.5CM - as described in hospitals' own price files.
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|
| Mat-Su Regional Medical Center | Palmer, AK | $50.70 | $128 | $169 | $18.12 - $162 |
| Providence Hood River Memorial Hospital | Hood River, OR | $333 | - | $444 | - |
| Providence Newberg Medical Center | Newberg, OR | $333 | - | $444 | - |
| Providence Seaside Hospital | Seaside, OR | $333 | - | $444 | - |
| Providence Medford Medical Center | Medford, OR | $333 | - | $444 | - |
| Providence Milwaukie Hospital | Milwaukie, OR | $333 | - | $444 | - |
| Providence St. Vincent Medical Center | Portland, OR | $333 | - | $444 | - |
| Providence Portland Medical Center | Portland, OR | $333 | - | $444 | - |
| Providence Willamette Falls Medical Center | Oregon City, OR | $333 | - | $444 | - |
| Flowers Hospital | Dothan, AL | $122 | $609 | $812 | $122 - $812 |
| Providence Cedars Sinai Tarzana Medical Center | Tarzana, CA | $1,872 | - | $5,348 | - |
| Saint John'S Health Center | Santa Monica, CA | $1,872 | - | $5,348 | - |
| Providence Little Co Of Mary Med Ctr San Pedro | San Pedro, CA | $1,872 | - | $5,348 | - |
| Providence Holy Cross Medical Center | Mission Hills, CA | $1,872 | - | $5,348 | - |
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | $1,872 | - | $5,348 | - |
| Providence Saint Joseph Medical Ctr | Burbank, CA | $1,872 | - | $5,348 | - |
| St. Patrick Hospital | Missoula, MT | $1,886 | - | $2,358 | - |
| Providence Valdez Medical Center | Valdez, AK | $2,269 | - | $2,910 | - |
| Healdsburg Hospital | Healdsburg, CA | $2,346 | - | $4,600 | - |
| Gadsden Regional Medical Center | Gadsden, AL | $443 | $2,459 | $3,690 | $310 - $3,690 |
| Providence Mount Carmel Hospital | Colville, WA | $2,536 | - | $3,622 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $2,536 | - | $3,622 | - |
| Kadlec Regional Medical Center | Richland, WA | $2,560 | - | $3,657 | - |
| Providence St. Mary Medical Center | Walla Walla, WA | $2,568 | - | $3,668 | - |
| Providence Holy Family Hospital | Spokane, WA | $2,657 | - | $3,796 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $2,732 | - | $5,692 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $2,732 | - | $5,692 | - |
| Swedish Issaquah | Issaquah, WA | $2,732 | - | $5,692 | - |
| Providence Redwood Memorial Hospital | Fortuna, CA | $2,856 | - | $5,600 | - |
| Covenant Hospital Levelland | Levelland, TX | $2,975 | - | $7,084 | - |
| Covenant Hospital Plainview | Plainview, TX | $2,975 | - | $7,084 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $2,975 | - | $7,084 | - |
| Covenant Medical Center | Lubbock, TX | $2,975 | - | $7,084 | - |
| Grace Surgical Hospital | Lubbock, TX | $3,014 | - | $7,176 | - |
| St. Mary Medical Center | Long Beach, CA | $3,213 | - | $6,693 | - |
| Providence Queen Of The Valley Medical Center | Napa, CA | $3,449 | - | $6,762 | - |
| Providence St. Jude Medical Center | Fullerton, CA | $3,544 | - | $7,383 | - |
| Providence St. Joseph Hospital | Eureka, CA | $3,682 | - | $7,670 | - |
| Petaluma Valley Hospital | Petaluma, CA | $3,683 | - | $7,222 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $3,683 | - | $7,222 | - |
| Providence Kodiak Island Medical Ctr | Kodiak, AK | $3,776 | - | $4,842 | - |
| Providence Centralia Hospital | Centralia, WA | $4,365 | - | $8,395 | - |
| Providence St. Peter Hospital | Olympia, WA | $4,365 | - | $8,395 | - |
| Providence Regional Medical Center Everett | Everett, WA | $4,503 | - | $8,660 | - |
| Providence Alaska Medical Center | Anchorage, AK | $5,920 | - | $7,590 | - |
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.