Code: Q4114

Description:
Description: Integra flowable wound matrix, injectable, 1 cc
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
INTEGRA FLW WM 1CC
SEALR WOUND MATRIX FLO 3 ML FWD301
INTEGRA FLOWABLE WOUND MATRIX, PER 1ML, 3 ML
INTEGRA FLOWABLE WOUND MATRIX INJECTABLE 1 CC
Related codes:
Code: Q4110
PRIMATRIX 64 SQCM
Code: Q4111
GAMMAGRAFT 12 SQCM
Code: Q4112
CYMETRA ALLOGRFT 1 CC
Code: Q4113
GRAFTJACKET XPRESS 1CC
Code: Q4115
GRAFT SOFT TISSUE FROZEN CADAVER
Code: Q4116
ALLODERM 1SQCM
Code: Q4117
HYALOMATRIX 100SQCM
Code: Q4118
MATRISTEM MICRO 1MG 100
Code: Q4119
Illinois
Hospital Address Code Price Last Updated
Adventist Bolingbrook Hospital 500 Remington Blvd, Bolingbrook Q4114 $1,491 [source] 4 years ago
Presence St. Mary's Hospital 500 W Court St, Kankakee Q4114 $1,984 [source] 4 years ago
Alexian Brothers Medical Center 935 Beisner Rd, Elk Grove Village Q4114 $2,604 [source] 4 years ago
Adventist Hinsdale Hospital 120 N Oak St, Hinsdale Q4114 $2,673 [source] 4 years ago
Adventist Lagrange Memorial Hospital 5101 Willow Springs Rd, La Grange Q4114 $2,695 [source] 4 years ago
Adventist Glenoaks Hospital 701 Winthrop Ave, Glendale Heights Q4114 $2,695 [source] 4 years ago
St. Alexius Medical Center 1555 Barrington Road, Q4114 $2,707 [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 ยง180.