GRAFT TISSUE AMNIOTIC MEMBRANE WOUND TRI BIOVANCE 3L DHAM024S 2X4CM - as described in hospitals' own price files.
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|
| Providence Redwood Memorial Hospital | Fortuna, CA | $5,963 | - | $11,693 | - |
| St. Patrick Hospital | Missoula, MT | $6,164 | - | $7,706 | - |
| Providence Cedars Sinai Tarzana Medical Center | Tarzana, CA | $6,617 | - | $18,906 | - |
| Saint John'S Health Center | Santa Monica, CA | $6,617 | - | $18,906 | - |
| Providence Little Co Of Mary Med Ctr San Pedro | San Pedro, CA | $6,617 | - | $18,906 | - |
| Providence Holy Cross Medical Center | Mission Hills, CA | $6,617 | - | $18,906 | - |
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | $6,617 | - | $18,906 | - |
| Providence Saint Joseph Medical Ctr | Burbank, CA | $6,617 | - | $18,906 | - |
| Kadlec Regional Medical Center | Richland, WA | $6,680 | - | $9,542 | - |
| Healdsburg Hospital | Healdsburg, CA | $6,854 | - | $13,440 | - |
| Providence St. Mary Medical Center | Walla Walla, WA | $7,934 | - | $11,334 | - |
| Providence Mount Carmel Hospital | Colville, WA | $8,467 | - | $12,096 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $8,467 | - | $12,096 | - |
| Covenant Hospital Levelland | Levelland, TX | $8,731 | - | $20,787 | - |
| Covenant Hospital Plainview | Plainview, TX | $8,731 | - | $20,787 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $8,731 | - | $20,787 | - |
| Covenant Medical Center | Lubbock, TX | $8,731 | - | $20,787 | - |
| Providence Holy Family Hospital | Spokane, WA | $8,840 | - | $12,629 | - |
| Providence Valdez Medical Center | Valdez, AK | $8,841 | - | $11,334 | - |
| Grace Surgical Hospital | Lubbock, TX | $8,881 | - | $21,146 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $8,881 | - | $18,502 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $8,881 | - | $18,502 | - |
| Swedish Issaquah | Issaquah, WA | $8,881 | - | $18,502 | - |
| Providence St. Joseph Hospital | Eureka, CA | $9,032 | - | $18,816 | - |
| Providence Hood River Memorial Hospital | Hood River, OR | $9,038 | - | $12,051 | - |
| Providence Newberg Medical Center | Newberg, OR | $9,038 | - | $12,051 | - |
| Providence Seaside Hospital | Seaside, OR | $9,038 | - | $12,051 | - |
| Providence Medford Medical Center | Medford, OR | $9,038 | - | $12,051 | - |
| Providence Milwaukie Hospital | Milwaukie, OR | $9,038 | - | $12,051 | - |
| Providence St. Vincent Medical Center | Portland, OR | $9,038 | - | $12,051 | - |
| Providence Portland Medical Center | Portland, OR | $9,038 | - | $12,051 | - |
| Providence Willamette Falls Medical Center | Oregon City, OR | $9,038 | - | $12,051 | - |
| Providence Kodiak Island Medical Ctr | Kodiak, AK | $9,295 | - | $11,917 | - |
| St. Mary Medical Center | Long Beach, CA | $10,429 | - | $21,728 | - |
| Providence Mission Hospital | Mission Viejo, CA | $10,752 | - | $22,400 | - |
| Providence Queen Of The Valley Medical Center | Napa, CA | $10,967 | - | $21,504 | - |
| Providence St. Jude Medical Center | Fullerton, CA | $11,526 | - | $24,013 | - |
| Providence Regional Medical Center Everett | Everett, WA | $12,137 | - | $23,341 | - |
| Providence Alaska Medical Center | Anchorage, AK | $13,279 | - | $17,024 | - |
| Petaluma Valley Hospital | Petaluma, CA | $13,937 | - | $27,328 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $13,937 | - | $27,328 | - |
| Providence Centralia Hospital | Centralia, WA | $15,538 | - | $29,882 | - |
| Providence St. Peter Hospital | Olympia, WA | $15,538 | - | $29,882 | - |
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.