Q4105 (HCPCS) by state — Price Transparency

HCPCS · across United States

Q4105 — Integra Drt Or Omnigraft

State-by-state median negotiated rates. Lower bars are cheaper states; the range bar shows the IQR (25th to 75th percentile within each state).

$198 National median

$105 – $1,624 IQR (p25 – p75)

1,584 hospitals filing

51 states

View hospital-by-hospital → Raw rate rows →

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Uninsured estimates use the cash / self-pay median for this code: $272.

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Median negotiated rate, by state

Ranked by typical (median) negotiated price. Hover for state-level IQR.

Median negotiated rate by state for Q4105 (HCPCS), with interquartile range
State	Median	p25	p75
MT	$44	$33	$81
LA	$51	$39	$56
MD	$53	$38	$62
NH	$59	$44	$74
NM	$66	$44	$137
CO	$88	$67	$333
MS	$119	$79	$191
SC	$120	$52	$127
OK	$123	$30	$162
OH	$125	$52	$184
UT	$127	$58	$134
AR	$127	$76	$3,342
GA	$131	$83	$308
PA	$133	$114	$2,419
NC	$137	$121	$228
MO	$138	$98	$249
RI	$143	$140	$505
TX	$144	$94	$256
CT	$150	$94	$272
AZ	$151	$93	$408
WI	$155	$69	$308
OR	$155	$138	$535
WY	$156	$123	$193
DE	$161	$161	$161
IN	$169	$88	$261
HI	$180	$63	$3,709
MI	$184	$134	$276
KS	$191	$83	$289
FL	$210	$106	$639
CA	$213	$80	$2,927
IL	$260	$132	$2,688
IA	$262	$155	$984
MN	$269	$113	$2,084
AK	$292	$258	$327
SD	$332	$300	$659
MA	$361	$117	$4,775
WA	$458	$153	$9,147
VA	$705	$133	$9,417
ID	$1,147	$256	$4,776
ND	$1,164	$164	$2,008
NY	$1,166	$146	$2,639
WV	$1,216	$311	$1,286
NJ	$1,345	$128	$3,115
KY	$1,355	$572	$9,732
NE	$1,449	$675	$2,064
TN	$2,970	$66	$10,708
DC	$5,154	$448	$10,378
NV	$5,399	$2,937	$8,843
ME	$5,635	$2,277	$10,894
AL	$7,043	$302	$11,830
VT	$7,760	$136	$14,681

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
State	Median	p25	p75	Min	Max	Hospitals	Payers	Rates

MT	$44	$33	$81	$24	$38,324	11	31	103
LA	$51	$39	$56	$32	$342	14	54	313
MD	$53	$38	$62	$38	$1,350	2 ⚠ thin data	4	10
NH	$59	$44	$74	$30	$760	11	19	129
NM	$66	$44	$137	$36	$63,713	11	44	148
CO	$88	$67	$333	$11	$8,339	50	72	1,406
MS	$119	$79	$191	$33	$3,426	7	68	235
SC	$120	$52	$127	$27	$422	24	26	307
OK	$123	$30	$162	$29	$842	24	108	395
OH	$125	$52	$184	$32	$17,825	63	192	3,810
UT	$127	$58	$134	$32	$483	29	49	450
AR	$127	$76	$3,342	$19	$12,031	7	71	186
GA	$131	$83	$308	$26	$19,868	32	56	437
PA	$133	$114	$2,419	$20	$146,063	57	110	1,668
NC	$137	$121	$228	$26	$11,340	37	76	1,769
MO	$138	$98	$249	$34	$4,260	26	140	1,304
RI	$143	$140	$505	$57	$786	4	4	18
TX	$144	$94	$256	$20	$34,880	170	386	11,148
CT	$150	$94	$272	$33	$5,872	9	9	63
AZ	$151	$93	$408	$32	$38,395	29	108	1,121
WI	$155	$69	$308	$32	$10,378	58	96	1,602
OR	$155	$138	$535	$35	$11,273	18	32	380
WY	$156	$123	$193	$108	$236	3	20	22
DE	$161	$161	$161	$146	$177	1 ⚠ thin data	15	20
IN	$169	$88	$261	$32	$30,408	37	147	1,354
HI	$180	$63	$3,709	$32	$13,939	12	19	177
MI	$184	$134	$276	$33	$37,933	58	398	5,826
KS	$191	$83	$289	$23	$780	8	31	247
FL	$210	$106	$639	$11	$47,406	117	175	4,418
CA	$213	$80	$2,927	$11	$67,095	133	320	5,868
IL	$260	$132	$2,688	$15	$45,377	59	149	1,325
IA	$262	$155	$984	$34	$3,491	22	90	1,835
MN	$269	$113	$2,084	$32	$12,835	36	39	1,088
AK	$292	$258	$327	$223	$362	1 ⚠ thin data	1	2
SD	$332	$300	$659	$228	$1,725	2 ⚠ thin data	4	10
MA	$361	$117	$4,775	$34	$10,649	23	251	892
WA	$458	$153	$9,147	$30	$33,478	36	41	790
VA	$705	$133	$9,417	$22	$36,340	32	69	941
ID	$1,147	$256	$4,776	$13	$16,012	9	154	1,114
ND	$1,164	$164	$2,008	$35	$11,273	12	33	239
NY	$1,166	$146	$2,639	$16	$38,441	83	258	4,756
WV	$1,216	$311	$1,286	$27	$1,355	7	20	152
NJ	$1,345	$128	$3,115	$32	$20,800	45	265	9,027
KY	$1,355	$572	$9,732	$36	$86,524	33	44	1,307
NE	$1,449	$675	$2,064	$34	$3,154	19	36	1,227
TN	$2,970	$66	$10,708	$26	$33,202	45	73	1,741
DC	$5,154	$448	$10,378	$32	$77,559	3	24	265
NV	$5,399	$2,937	$8,843	$30	$39,189	17	98	900
ME	$5,635	$2,277	$10,894	$38	$25,796	8	10	118
AL	$7,043	$302	$11,830	$32	$31,800	22	90	606
VT	$7,760	$136	$14,681	$34	$38,473	4	29	172