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HCPCS V2790
GRAFT TISSUE OPHTHALMIC OCULAR 500 900UM AMNIOGUARD AGD1075 0.75X1.0CM - as described in hospitals' own price files.
98hospitals publishing a price
$1,986median cash price
$2,694median typical insurance price
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|---|---|---|---|---|
| Lakewood Ranch Medical Center | Bradenton, FL | - | $67.83 | $278 | $33.36 - $15,012 |
| Robert Wood Johnson University Hospital At Hamilton | Hamilton, NJ | $218 | - | $1,330 | $162 - $7,059 |
| Robert Wood Johnson University Hospital - Somerset | Somerville, NJ | $225 | - | $1,330 | $192 - $7,597 |
| Robert Wood Johnson University Hospital | New Brunswick, NJ | $284 | - | $1,330 | $181 - $6,909 |
| Merit Health River Region | Vicksburg, MS | $203 | $530 | $1,126 | $113 - $1,126 |
| St. Joseph'S Medical Center Of Stockton | Stockton, CA | $615 | - | $2,261 | $565 - $2,261 |
| Chi St. Luke'S Health Brazosport | Lake Jackson, TX | $657 | - | $1,878 | $225 - $2,929 |
| Northridge Hospital Medical Center | Northridge, CA | $844 | - | $3,142 | $628 - $5,315 |
| Chandler Regional Medical Center | Chandler, AZ | $880 | - | $3,173 | $444 - $2,665 |
| Community Hospital Of San Bernardino | San Bernardino, CA | $1,091 | - | $2,805 | $561 - $4,745 |
| Bakersfield Memorial Hospital | Bakersfield, CA | $1,174 | - | $3,230 | $808 - $3,230 |
| Orange County Global Medical Center | Santa Ana, CA | $1,446 | - | $2,780 | - |
| Los Angeles General Medical Center | Los Angeles, CA | $1,446 | - | $2,780 | - |
| Lompoc Valley Medical Center | Lompoc, CA | $1,446 | - | $2,780 | - |
| Oro Valley Hospital | Oro Valley, AZ | $1,172 | $1,460 | $4,882 | $488 - $4,394 |
| Providence Cedars Sinai Tarzana Medical Center | Tarzana, CA | $1,578 | - | $4,508 | - |
| Saint John'S Health Center | Santa Monica, CA | $1,578 | - | $4,508 | - |
| Providence Little Co Of Mary Med Ctr San Pedro | San Pedro, CA | $1,578 | - | $4,508 | - |
| Providence Holy Cross Medical Center | Mission Hills, CA | $1,578 | - | $4,508 | - |
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | $1,578 | - | $4,508 | - |
| Providence Saint Joseph Medical Ctr | Burbank, CA | $1,578 | - | $4,508 | - |
| San Francisco VA Medical Center | San Francisco, CA | $1,603 | - | $2,862 | - |
| San Mateo Medical Center | San Mateo, CA | $1,603 | - | $2,862 | - |
| Tri-City Medical Center | Oceanside, CA | $1,603 | - | $2,862 | - |
| Santa Clara Valley Medical Center | San Jose, CA | $1,603 | - | $2,862 | - |
| Sutter Medical Center, Sacramento | Sacramento, CA | $1,603 | - | $2,862 | - |
| Sutter Roseville Medical Center | Roseville, CA | $1,603 | - | $2,862 | - |
| Medstar Union Memorial Hospital | Baltimore, MD | $1,606 | $1,639 | $1,639 | $1,234 - $1,905 |
| Chi St. Joseph Health Regional Hospital | Bryan, TX | $1,698 | - | $9,703 | $1,941 - $9,703 |
| East Georgia Regional Medical Center | Statesboro, GA | $860 | $1,752 | $3,186 | $182 - $3,186 |
| St. Patrick Hospital | Missoula, MT | $1,784 | - | $2,230 | - |
| Medstar Harbor Hospital | Baltimore, MD | $1,320 | $1,871 | $1,347 | $1,320 - $2,175 |
| Providence Portland Medical Center | Portland, OR | $1,873 | - | $2,497 | - |
| Methodist Hospital Of Sacramento | Sacramento, CA | $1,942 | - | $8,025 | $645 - $7,945 |
| Wellington Regional Medical Center | Wellington, FL | $2,251 | $1,976 | $5,627 | $844 - $7,094 |
| Penn State Health St. Joseph | Reading, PA | $602 | $1,976 | $2,316 | $488 - $16,000 |
| Healdsburg Hospital | Healdsburg, CA | $1,984 | - | $3,891 | - |
| Providence Hood River Memorial Hospital | Hood River, OR | $1,986 | - | $2,648 | - |
| Providence Newberg Medical Center | Newberg, OR | $1,986 | - | $2,648 | - |
| Providence Seaside Hospital | Seaside, OR | $1,986 | - | $2,648 | - |
| Providence Medford Medical Center | Medford, OR | $1,986 | - | $2,648 | - |
| Providence Milwaukie Hospital | Milwaukie, OR | $1,986 | - | $2,648 | - |
| Providence St. Vincent Medical Center | Portland, OR | $1,986 | - | $2,648 | - |
| Providence Willamette Falls Medical Center | Oregon City, OR | $1,986 | - | $2,648 | - |
| Medstar Montgomery Medical Center | Olney, MD | $1,411 | $2,026 | $1,440 | $1,411 - $2,355 |
| Providence Mount Carmel Hospital | Colville, WA | $2,119 | - | $3,027 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $2,119 | - | $3,027 | - |
| Penn State Health Holy Spirit Medical Center | Camp Hill, PA | $553 | $2,119 | $2,316 | $685 - $16,000 |
| Penn State Health Hampden Medical Center | Enola, PA | $1,127 | $2,151 | $3,580 | $127 - $16,000 |
| Medstar Franklin Square Medical Center | Rosedale, MD | $1,609 | $2,171 | $1,642 | $1,609 - $2,524 |
| Providence St. Mary Medical Center | Walla Walla, WA | $2,186 | - | $3,122 | - |
| Milton S Hershey Medical Center | Hershey, PA | $767 | $2,201 | $2,316 | $342 - $16,000 |
| Providence Holy Family Hospital | Spokane, WA | $2,221 | - | $3,173 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $2,300 | - | $4,792 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $2,300 | - | $4,792 | - |
| Swedish Issaquah | Issaquah, WA | $2,300 | - | $4,792 | - |
| Chi-St Vincent Infirmary | Little Rock, AR | $2,309 | - | $9,000 | $499 - $4,500 |
| Kadlec Regional Medical Center | Richland, WA | $2,464 | - | $3,520 | - |
| Mercy Gilbert Medical Center | Gilbert, AZ | $2,496 | - | $4,968 | $382 - $4,968 |
| Providence Redwood Memorial Hospital | Fortuna, CA | $2,560 | - | $5,020 | - |
| Covenant Hospital Levelland | Levelland, TX | $2,591 | - | $6,168 | - |
| Covenant Hospital Plainview | Plainview, TX | $2,591 | - | $6,168 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $2,591 | - | $6,168 | - |
| Covenant Medical Center | Lubbock, TX | $2,591 | - | $6,168 | - |
| Providence Valdez Medical Center | Valdez, AK | $2,620 | - | $3,359 | - |
| Providence Mission Hospital | Mission Viejo, CA | $2,624 | - | $5,466 | - |
| Medstar Good Samaritan Hospital | Baltimore, MD | $1,986 | $2,631 | $2,026 | $1,986 - $3,058 |
| St. Mary Medical Center | Long Beach, CA | $2,706 | - | $5,637 | - |
| Medstar Southern Maryland Hospital Center | Clinton, MD | $1,856 | $2,757 | $1,894 | $1,856 - $3,204 |
| Medstar Saint Mary'S Hospital | Leonardtown, MD | $1,899 | $2,814 | $1,938 | $1,899 - $3,271 |
| Providence Queen Of The Valley Medical Center | Napa, CA | $2,899 | - | $5,685 | - |
| Grace Surgical Hospital | Lubbock, TX | $2,901 | - | $6,908 | - |
| St. Elizabeth Community Hospital | Red Bluff, CA | $2,951 | - | $4,968 | $365 - $4,968 |
| Grandview Medical Center | Birmingham, AL | $970 | $2,976 | $6,469 | $640 - $6,469 |
| Mercy Hospital Of Folsom | Folsom, CA | $2,994 | - | $8,025 | $309 - $8,025 |
| Corona Regional Medical Center | Corona, CA | - | $3,033 | $3,253 | $914 - $9,716 |
| Christus St. Frances Cabrini Hospital | Alexandria, LA | $3,040 | - | $11,691 | $1,403 - $11,691 |
| Petaluma Valley Hospital | Petaluma, CA | $3,054 | - | $5,988 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $3,054 | - | $5,988 | - |
| Providence St. Joseph Hospital | Eureka, CA | $3,098 | - | $6,453 | - |
| St. Luke'S Patients Medical Center | Pasadena, TX | $3,113 | - | $8,894 | $163 - $24,798 |
| Northern Nevada Medical Center | Sparks, NV | - | $3,213 | $11,517 | $1,404 - $8,292 |
| Providence St. Jude Medical Center | Fullerton, CA | $3,233 | - | $6,735 | - |
| Providence Kodiak Island Medical Ctr | Kodiak, AK | $3,287 | - | $4,214 | - |
| Eastern New Mexico Medical Center | Roswell, NM | $923 | $3,405 | $4,394 | $439 - $4,174 |
| Providence Centralia Hospital | Centralia, WA | $3,627 | - | $6,975 | - |
| Providence St. Peter Hospital | Olympia, WA | $3,627 | - | $6,975 | - |
| Aiken Regional Medical Center | Aiken, SC | $3,311 | $3,760 | $8,278 | $2,318 - $7,630 |
| Providence Regional Medical Center Everett | Everett, WA | $3,790 | - | $7,288 | - |
| Plains Regional Medical Center | Clovis, NM | $1,713 | $3,996 | $6,343 | $953 - $5,582 |
| Christus Southeast Texas- St. Elizabeth | Beaumont, TX | $4,249 | - | $12,876 | $518 - $12,039 |
| George Washington Univ Hospital | Washington, DC | $1,692 | $5,088 | $4,230 | $1,184 - $23,900 |
| Providence Alaska Medical Center | Anchorage, AK | $5,182 | - | $6,643 | - |
| Wilkes-Barre General Hospital | Wilkes-Barre, PA | $6,216 | $5,310 | $25,902 | $2,075 - $25,902 |
| Northwest Health - Porter | Valparaiso, IN | $3,228 | $5,881 | $11,954 | $350 - $11,954 |
| Flowers Hospital | Dothan, AL | $2,788 | $14,871 | $18,589 | $1,859 - $18,589 |
| Dupont Hospital LLC | Fort Wayne, IN | $12,439 | $23,034 | $46,069 | $350 - $41,462 |
| Bluffton Regional Medical Center | Bluffton, IN | $14,103 | $33,224 | $58,762 | $350 - $52,886 |
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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