Code: Q4101

Description:
Description: Apligraf, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
Apligraf 7.5 Cm
GRAFT APLIGRAF 7.5CM BOVINE COLLAGEN MATRIX HUMAN FIBROBLAST .75MM SKIN
Drsg Apligraf (free) Per Sq Cm
APLIGRAF 44CM PER SQ CM
SKIN GRAFT, APLIGRAF
APLIGRAF 44.2 PER SQCM
HC APLIGRAF PER SQ CM
APLIGRAF PER SQ CM
APLIGRAF N/MCARE 1 UNIT Q
Related codes:
Code: Q4100
SKIN SUBSTITUTE NOS
Code: Q4102
OASIS WND MATRX 21 SQCM
Code: Q4103
OASIS BURN MATRIX 1SQCM
Code: Q4104
INTEGRA BMWD 1SQCM
Code: Q4105
INTEGRA DRTOMNIGF 1SQCM
Code: Q4106
DERMAGRAFT 37.5 SQCM
Code: Q4107
GRAFTJACKET 8 SQCM
Code: Q4108
INTEGRA MATRIX 25 SQCM
Code: Q4109
SKIN SUBSTITUTE TISSUEMEND PER SQ CM
Texas
Hospital Address Code Price Last Updated
Ennis Regional Medical Center 2201 West Lampasas, Waxahachie Q4101 $19 [source] 4 years ago
Rio Grande Regional Hospital 101 East Ridge Road, Mcallen Q4101 $44 [source] 4 years ago
Paris Regional Medical Center 865 Deshong Drive, Paris Q4101 $57 [source] 4 years ago
Ascension Providence 6901 Medical Pkwy, Woodway Q4101 $73 [source] 4 years ago
Baylor Scott & White Medical Center - Taylor 305 Mallard Ln, Taylor Q4101 $112 [source] 4 years ago
Baylor Scott & White Medical Center - Marble Falls 810 W. State Highway 71, Marble Falls Q4101 $112 [source] 4 years ago
Baylor Scott & White Medical Center - College Station 700 Scott And White Dr, College Station Q4101 $120 [source] 4 years ago
Baylor Scott & White Medical Center - Lakeway 100 Medical Pkwy, Austin Q4101 $125 [source] 4 years ago
Baylor Scott & White Medical Center - Buda 5330 Overpass Rd, Buda Q4101 $125 [source] 4 years ago
Baylor Scott & White Medical Center - Round Rock 300 University Blvd, Sandy Q4101 $125 [source] 4 years ago
Baylor Scott & White Medical Center - Pflugerville 2600 E Pflugerville Pkwy Ste 100, Pflugerville Q4101 $125 [source] 4 years ago
Baylor Scott & White Medical Center - Brenham 700 Medical Pkwy, Brenham Q4101 $127 [source] 4 years ago
Baylor Scott & White Continuing Care Hospital - Temple 546 N Kegley Rd, Temple Q4101 $187 [source] 4 years ago
Texas Health Huguley 11801 South Fwy, Burleson Q4101 $227 [source] 4 years ago
Adventhealth Central Texas 2201 Clear Creek Rd, Killeen Q4101 $331 [source] 4 years ago
Adventhealth Rollins Brook 608 N Key Ave, Lampasas Q4101 $331 [source] 4 years ago
Medical City Dallas 13155 Noel Rd. Suite 200, Dallas Q4101 $362 [source] 4 years ago
Medical City Frisco 5500 Frisco Square Blvd, Frisco Q4101 $469 [source] 4 years ago
Medical City North Hills 4401 Booth Calloway Rd, North Richland Hills Q4101 $545 [source] 4 years ago
South Texas Health System Mcallen 301 W. Expressway 83, Mcallen Q4101 $3,407 [source] 4 years ago
South Texas Health System Children’s 1102 W. Trenton Road, Edinburg Q4101 $3,407 [source] 4 years ago
South Texas Health System Heart 1900 South D Street, Mcallen Q4101 $3,407 [source] 4 years ago
Texoma Medical Center 5016 South Us Highway 75, Denison Q4101 $4,407 [source] 4 years ago
Northwest Texas Healthcare System 1501 S. Coulter, Amarillo Q4101 $4,482 [source] 4 years ago
Baylor Scott & White All Saints Medical Center - Fort Worth 1400 8Th Ave, Fort Worth Q4101 $4,734 [source] 4 years ago
Baylor Scott & White Medical Center - Centennial 12505 Lebanon Rd, Frisco Q4101 $4,734 [source] 4 years ago
Baylor Scott & White Emergency Center - Forney 757 E Us Highway 80 Ste 150, Forney Q4101 $4,734 [source] 4 years ago
Baylor Scott & White Medical Center - Irving 1901 N Macarthur Blvd, Irving Q4101 $4,734 [source] 4 years ago
Baylor Scott & White Emergency Hospital - Murphy 511 W Fm 544 Ste 100, Plano Q4101 $4,734 [source] 4 years ago
Baylor Scott & White Heart And Vascular Hospital - Dallas 621 N Hall St, Dallas Q4101 $4,734 [source] 4 years ago
Baylor Scott & White Emergency Hospital - Aubrey 26791 Us Highway 380 E, Aubrey Q4101 $4,734 [source] 4 years ago
Baylor Scott & White Medical Center - Waxahachie 2400 N Interstate 35E, Waxahachie Q4101 $4,734 [source] 4 years ago
Baylor Scott & White Medical Center - Lake Pointe 6800 Scenic Dr, Rowlett Q4101 $4,734 [source] 4 years ago
Doctors Hospital Of Laredo 10700 Mcpherson Road, Laredo Q4101 $4,804 [source] 4 years ago
Baylor Scott & White Medical Center - Grapevine 1650 W College St, Grapevine Q4101 $4,970 [source] 4 years ago
Baylor Scott & White Medical Center - Plano 4700 Alliance Blvd, Plano Q4101 $5,523 [source] 4 years ago
Baylor Scott & White The Heart Hospital - Denton 2801 S Mayhill Rd, Denton Q4101 $5,523 [source] 4 years ago
Baylor Scott & White The Heart Hospital - Plano 1100 Allied Dr, Plano Q4101 $5,523 [source] 4 years ago
St. David's Healthcare , Round Rock Q4101 $7,528 [source] 4 years ago
Palestine Regional Medical Center 2900 South Loop 256, Palestine Q4101 $8,530 [source] 4 years ago
Fort Duncan Regional Medical Center 3333 N. Foster Maldonado Blvd., Eagle Pass Q4101 $13,930 [source] 4 years ago
Medical City Weatherford 713 E Anderson St, Weatherford Q4101 $14,025 [source] 4 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR §180.