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HCPCS Q4186
OFF CONTRACT - ALGRFT EPIXL FEN STRD 4X10CM - as described in hospitals' own price files.
113hospitals publishing a price
$456median cash price
$886median typical insurance price
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|---|---|---|---|---|
| San Francisco VA Medical Center | San Francisco, CA | $16.80 | - | $30.00 | - |
| San Mateo Medical Center | San Mateo, CA | $16.80 | - | $30.00 | - |
| Tri-City Medical Center | Oceanside, CA | $16.80 | - | $30.00 | - |
| Santa Clara Valley Medical Center | San Jose, CA | $16.80 | - | $30.00 | - |
| Sutter Medical Center, Sacramento | Sacramento, CA | $16.80 | - | $30.00 | - |
| Sutter Roseville Medical Center | Roseville, CA | $16.80 | - | $30.00 | - |
| Robert Wood Johnson University Hospital At Hamilton | Hamilton, NJ | $148 | - | $905 | $113 - $770 |
| George Washington Univ Hospital | Washington, DC | $206 | $150 | $515 | $142 - $47,550 |
| Robert Wood Johnson University Hospital - Somerset | Somerville, NJ | $153 | - | $905 | $135 - $828 |
| Lakewood Ranch Medical Center | Bradenton, FL | - | $158 | $636 | $76.32 - $34,344 |
| Oro Valley Hospital | Oro Valley, AZ | $117 | $171 | $486 | $57.58 - $515 |
| Allen County Regional Hospital | Iola, KS | $189 | - | $315 | $110 - $4,939 |
| Robert Wood Johnson University Hospital | New Brunswick, NJ | $193 | - | $905 | $145 - $753 |
| Merit Health Wesley | Hattiesburg, MS | $119 | $203 | $566 | $63.34 - $566 |
| Methodist Hospital Of Sacramento | Sacramento, CA | $236 | - | $975 | $101 - $3,779 |
| St. Joseph'S Medical Center Of Stockton | Stockton, CA | $245 | - | $900 | $87.75 - $22,298 |
| Dominican Hospital | Santa Cruz, CA | $293 | - | $663 | $152 - $2,606 |
| East Georgia Regional Medical Center | Statesboro, GA | $129 | $306 | $478 | $23.68 - $1,547 |
| Providence Cedars Sinai Tarzana Medical Center | Tarzana, CA | $334 | - | $953 | - |
| Mercy Hospital Of Folsom | Folsom, CA | $364 | - | $975 | $48.40 - $2,184 |
| Providence Hood River Memorial Hospital | Hood River, OR | $375 | - | $501 | - |
| Providence Newberg Medical Center | Newberg, OR | $375 | - | $501 | - |
| Providence Seaside Hospital | Seaside, OR | $375 | - | $501 | - |
| Providence Medford Medical Center | Medford, OR | $375 | - | $501 | - |
| Providence Milwaukie Hospital | Milwaukie, OR | $375 | - | $501 | - |
| Providence St. Vincent Medical Center | Portland, OR | $375 | - | $501 | - |
| Providence Portland Medical Center | Portland, OR | $375 | - | $501 | - |
| Providence Willamette Falls Medical Center | Oregon City, OR | $375 | - | $501 | - |
| Regional Hospital Of Scranton | Scranton, PA | $384 | $379 | $1,423 | $122 - $1,339 |
| Covenant Medical Center | Lubbock, TX | $391 | - | $931 | - |
| Ohiohealth Shelby Hospital | Shelby, OH | $392 | - | $603 | - |
| Healdsburg Hospital | Healdsburg, CA | $398 | - | $781 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $401 | - | $836 | - |
| Swedish Issaquah | Issaquah, WA | $401 | - | $836 | - |
| Berger Hospital | Circleville, OH | $407 | - | $626 | - |
| Doctors Hospital | Columbus, OH | $407 | - | $626 | - |
| Grady Memorial Hospital | Delaware, OH | $407 | - | $626 | - |
| Dublin Methodist Hospital | Dublin, OH | $407 | - | $626 | - |
| Hardin Memorial Hospital | Kenton, OH | $407 | - | $626 | - |
| Grant Medical Center | Columbus, OH | $407 | - | $626 | - |
| Ohiohealth O'Bleness Hospital | Athens, OH | $407 | - | $626 | - |
| Riverside Methodist Hospital | Columbus, OH | $407 | - | $626 | - |
| Gadsden Regional Medical Center | Gadsden, AL | $71.40 | $414 | $595 | $71.40 - $1,525 |
| Chandler Regional Medical Center | Chandler, AZ | $415 | - | $1,495 | $94.08 - $2,129 |
| Chi St. Luke'S Health Brazosport | Lake Jackson, TX | $420 | - | $1,199 | $180 - $16,142 |
| North Okaloosa Medical Center | Crestview, FL | $129 | $450 | $715 | $107 - $15,630 |
| Kadlec Regional Medical Center | Richland, WA | $456 | - | $652 | - |
| St. Luke'S Patients Medical Center | Pasadena, TX | $458 | - | $1,307 | $220 - $6,862 |
| Moberly Regional Medical Center | Moberly, MO | $216 | $532 | $801 | $160 - $659 |
| Bakersfield Memorial Hospital | Bakersfield, CA | $532 | - | $1,465 | $97.50 - $44,595 |
| Grandview Medical Center | Birmingham, AL | $133 | $533 | $888 | $133 - $888 |
| Sierra Nevada Memorial Hospital | Grass Valley, CA | $577 | - | $1,038 | $139 - $2,286 |
| Wilkes-Barre General Hospital | Wilkes-Barre, PA | $412 | $623 | $1,717 | $138 - $1,717 |
| Providence Regional Medical Center Everett | Everett, WA | $647 | - | $1,245 | - |
| Providence Alaska Medical Center | Anchorage, AK | $665 | - | $853 | - |
| Mat-Su Regional Medical Center | Palmer, AK | $264 | $668 | $879 | $94.23 - $844 |
| Western Arizona Regional Medical Center | Bullhead City, AZ | $161 | $670 | $1,340 | $53.56 - $1,273 |
| Chi St. Joseph Health Regional Hospital | Bryan, TX | $695 | - | $3,973 | $158 - $9,402 |
| Northwest Health - Porter | Valparaiso, IN | $414 | $754 | $1,532 | $149 - $1,348 |
| St. Patrick Hospital | Missoula, MT | $762 | - | $953 | - |
| Novant Health Rowan Medical Center | Salisbury, NC | $797 | - | $1,594 | $121 - $1,546 |
| Carlsbad Medical Center | Carlsbad, NM | $117 | $851 | $1,166 | $117 - $1,084 |
| Spring Valley Hospital Medical Center | Las Vegas, NV | - | $855 | $1,907 | $150 - $5,587 |
| Henderson Hospital | Henderson, NV | - | $886 | $1,907 | $150 - $5,587 |
| Plains Regional Medical Center | Clovis, NM | $426 | $1,087 | $1,576 | $426 - $1,387 |
| Mercy Gilbert Medical Center | Gilbert, AZ | $1,135 | - | $2,259 | $102 - $31,215 |
| Corona Regional Medical Center | Corona, CA | - | $1,199 | $14,174 | $159 - $33,382 |
| St. Elizabeth Community Hospital | Red Bluff, CA | $1,342 | - | $2,259 | $97.44 - $31,215 |
| Northern Nevada Medical Center | Sparks, NV | - | $1,404 | $4,027 | $150 - $47,874 |
| Crestwood Medical Center | Huntsville, AL | $828 | $1,462 | $4,598 | $111 - $4,598 |
| Aiken Regional Medical Center | Aiken, SC | $2,426 | $1,554 | $6,065 | $83.49 - $5,489 |
| Wellington Regional Medical Center | Wellington, FL | $4,275 | $1,679 | $10,688 | $288 - $14,510 |
| Temecula Valley Hospital | Temecula, CA | - | $1,838 | $2,252 | $152 - $21,578 |
| Bluffton Regional Medical Center | Bluffton, IN | $692 | $2,163 | $2,884 | $149 - $4,167 |
| Chi-St Vincent Infirmary | Little Rock, AR | $2,252 | - | $8,775 | $117 - $4,388 |
| Community Hospital Of San Bernardino | San Bernardino, CA | $2,399 | - | $6,170 | $67.00 - $50,410 |
| Grace Surgical Hospital | Lubbock, TX | $2,810 | - | $6,689 | - |
| Orange County Global Medical Center | Santa Ana, CA | $4,779 | - | $9,190 | - |
| Los Angeles General Medical Center | Los Angeles, CA | $4,779 | - | $9,190 | - |
| Lompoc Valley Medical Center | Lompoc, CA | $4,779 | - | $9,190 | - |
| Providence Redwood Memorial Hospital | Fortuna, CA | $4,864 | - | $9,537 | - |
| Medstar Union Memorial Hospital | Baltimore, MD | $4,237 | $4,872 | $4,324 | $874 - $11,113 |
| Saint John'S Health Center | Santa Monica, CA | $4,943 | - | $14,124 | - |
| Providence Little Co Of Mary Med Ctr San Pedro | San Pedro, CA | $4,943 | - | $14,124 | - |
| Providence Holy Cross Medical Center | Mission Hills, CA | $4,943 | - | $14,124 | - |
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | $4,943 | - | $14,124 | - |
| Providence Saint Joseph Medical Ctr | Burbank, CA | $4,943 | - | $14,124 | - |
| Providence St. Mary Medical Center | Walla Walla, WA | $6,075 | - | $8,679 | - |
| Medstar Harbor Hospital | Baltimore, MD | $2,486 | $6,168 | $2,537 | $934 - $14,816 |
| Providence Valdez Medical Center | Valdez, AK | $6,512 | - | $8,349 | - |
| Medstar Franklin Square Medical Center | Rosedale, MD | $2,752 | $6,513 | $2,808 | $1,139 - $14,925 |
| Covenant Hospital Levelland | Levelland, TX | $6,764 | - | $16,104 | - |
| Covenant Hospital Plainview | Plainview, TX | $6,764 | - | $16,104 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $6,764 | - | $16,104 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $6,811 | - | $14,190 | - |
| Medstar Montgomery Medical Center | Olney, MD | $2,729 | $6,862 | $2,785 | $999 - $16,709 |
| Providence Mount Carmel Hospital | Colville, WA | $6,884 | - | $9,834 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $6,884 | - | $9,834 | - |
| Providence Holy Family Hospital | Spokane, WA | $7,204 | - | $10,291 | - |
| Providence St. Joseph Hospital | Eureka, CA | $7,366 | - | $15,345 | - |
| Providence Kodiak Island Medical Ctr | Kodiak, AK | $7,568 | - | $9,702 | - |
| Medstar Good Samaritan Hospital | Baltimore, MD | $3,285 | $7,657 | $3,352 | $1,406 - $17,285 |
| St. Mary Medical Center | Long Beach, CA | $7,999 | - | $16,665 | - |
| Providence Mission Hospital | Mission Viejo, CA | $8,078 | - | $16,830 | - |
| Providence Queen Of The Valley Medical Center | Napa, CA | $8,583 | - | $16,830 | - |
| Providence St. Jude Medical Center | Fullerton, CA | $8,839 | - | $18,414 | - |
| Medstar Southern Maryland Hospital Center | Clinton, MD | $3,813 | $9,849 | $3,891 | $1,314 - $24,633 |
| Medstar Saint Mary'S Hospital | Leonardtown, MD | $3,918 | $10,184 | $3,998 | $1,345 - $25,633 |
| Petaluma Valley Hospital | Petaluma, CA | $10,334 | - | $20,262 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $10,334 | - | $20,262 | - |
| Providence Centralia Hospital | Centralia, WA | $11,669 | - | $22,440 | - |
| Providence St. Peter Hospital | Olympia, WA | $11,669 | - | $22,440 | - |
| Flowers Hospital | Dothan, AL | $2,552 | $12,760 | $17,013 | $153 - $17,013 |
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.
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