What does code Q4128 cost?

Across the published hospital price files, the disclosed cash price for Q4128 ranges from $24.51 to $44,330. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Will this be my final bill?

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

Q4128 is the billing code hospitals use to identify "Noncdm Charge Record Medical Supplies" on their published price files. We use it to line up the same service across different hospitals.

Why do prices for this code differ between hospitals?

Each hospital sets its own prices and negotiates separately with each insurer, so the disclosed price for the same code can vary widely from one hospital to another — and even between plans at a single hospital. Comparing the published figures is what this page is for; a difference does not by itself mean one hospital is better or worse.

What this page is not

It is not a quote, a guarantee, or medical advice. It shows what hospitals have published for this code, so you can compare and ask informed questions — your actual cost depends on your insurance, the exact services performed, and the care setting.

Q4128

HCPCS

Noncdm Charge Record Medical Supplies

Verified from hospital fileNot a bill estimate

iDirect answer

Based on the latest published hospital price files, code Q4128 (Noncdm Charge Record Medical Supplies) appears at 29 hospitals with disclosed cash prices from $24.51 to $44,330. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Published-price availability

hospitals publish a price

list this service without a published price

251

Cash

251

List

227

Negotiated

Allowed

A blank price (“—”) means a hospital names this service but did not publish a dollar amount — it is not a free service or a $0 price.

Compare Q4128 prices

Filter by hospital, city, setting, or payer — the summary and charts update with your filters.

Based on hospital-published prices verified from each hospital’s own file. Coverage expands as data is verified.

Published cash prices for code Q4128 vary by about 1809× across the 28 hospitals with disclosed prices here — from $24.51 to $44,330. Shopping around can matter.

Hospitals

253

Prices shown

$24.51

Lowest cash

$44,330

Highest cash

code Q4128 cash price251 disclosed · 28 hospitals

$24.51median ~$77.57$44,330

Lowest cash price by hospital

Cash price by city

Reflects your current filters.

Cash price by city$24.51 – $277

Torrance · 1 hospital$24.51–$45.63
Burbank · 1 hospital$25.81–$27.57
Tarzana · 1 hospital$26.34
Mission Hills · 1 hospital$26.34–$38.17
Arlington · 2 hospitals$41.09–$277
Flower Mound · 1 hospital$41.09–$277

253 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
Noncdm Charge Record Medical Supplies Inpatient & outpatient	University of Chicago Medical Center	Q4128 HCPCS	—	—	—	—
Flexhd/allopatchhd/matrixhd Outpatient	University of Chicago Medical Center	Q4128 HCPCS	—	—	—	—
HC OR 636 Q4128 FLEXHD ALLOPATCH HD PER SQ CM Inpatient	Deaconess Gateway Hospital	Q4128 HCPCS	$3,290	$1,086	$1,086 – $2,896	—
GRAFT FLEXHD PRE ACE MEDIUM 19 X 22 CM 0.7-1.4MM Inpatient	Memorial Hospital of South Bend	Q4128 CPT	$68,200	$44,330	$13,640 – $55,924	—
GRAFT ALLODERM RTU 2X4CM THIN48869 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$401	$341	$87.82 – $381	—
GRAFT ALLODERM RTU 3X7CM THIN MED THICK48871 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$1,426	$1,212	$87.82 – $1,355	—
GRAFT ALLOPATCH HD THICK 4X8CM70547 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$3,968	$3,373	$87.82 – $3,770	—
GRAFT DERMIS HYDRATED ACELLULAR FLEXHD 3X748415 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$1,066	$906	$87.82 – $1,013	—
GRAFT DERMIS HYDRATED ACELLULAR FLEXHD 12X24CM51954 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$18,171	$15,445	$87.82 – $17,262	—
GRAFT FLEX HD PLIABLE 8X16CM59122 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$8,605	$7,314	$87.82 – $8,175	—
GRAFT FLEX HD PLIABLE KIT 6X16CM Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$6,112	$5,195	$87.82 – $5,806	—
GRAFT FLEX HD PLIABLE KIT PERFORATED 13CMX22CM70586 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$22,596	$19,207	$87.82 – $21,466	—
GRAFT FLEX HD PLIABLE PREFORATED SHAPED THICK 1.5-2.2MM74925 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$11,298	$9,603	$87.82 – $10,733	—
GRAFT STRATTICE 20X25CM FIRM70744 Outpatient	Paul Oliver Memorial Hospital	Q4128 HCPCS	$29,648	$25,201	$87.82 – $28,166	—
GRAFT ALLODERM RTU 12X20CM MED THICK54933 Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$20,440	$17,374	$64.85 – $17,374	—
GRAFT ALLODERM RTU 3X7CM THIN MED THICK48871 Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$1,426	$1,212	$64.85 – $1,212	—
GRAFT ALLODERM RTU 4X7CM THICK70491 Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$2,783	$2,366	$64.85 – $2,366	—
GRAFT ALLODERM RTU 5X10CM MED THICK65150 Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$2,886	$2,453	$64.85 – $2,453	—
GRAFT ALLODERM RTU 8X12CM MED THICK65151 Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$6,180	$5,253	$64.85 – $5,253	—
GRAFT FLEX HD PLIABLE KIT 6X16CM Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$6,112	$5,195	$64.85 – $5,195	—
GRAFT FLEX HD PLIABLE KIT 8X16CM Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$8,605	$7,314	$64.85 – $7,314	—
GRAFT FLEX HD PLIABLE KIT PERFORATED 11X20CM69220 Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$18,180	$15,453	$64.85 – $15,453	—
GRAFT STRATTICE 20X30CM FIRM64393 Outpatient	Munson Healthcare Grayling	Q4128 HCPCS	$33,962	$28,868	$64.85 – $28,868	—
ALLOGRAFT FLEXHD 16X20/320SQCM Outpatient	Texas Health Presbyterian Hospital Allen	Q4128 HCPCS	$129	$77.57	$14.89 – $141	—
ALLOGRAFT FLEXHD 12X16/192SQCM Outpatient	Texas Health Presbyterian Hospital Allen	Q4128 HCPCS	$134	$80.18	$15.39 – $141	—

How to read these prices

Cash price: The discounted self-pay price for paying directly, without insurance.
List price: The hospital’s full undiscounted charge — rarely what anyone pays.
Negotiated rate: A rate for a specific insurer and plan; your share depends on your benefits.
Allowed amount: A historical reference for what was actually allowed, where disclosed.

Hospitals that publish Q4128 prices

Open a hospital to see this code in the context of its full published prices.

University of Chicago Medical Center Deaconess Gateway Hospital Memorial Hospital of South Bend Paul Oliver Memorial Hospital Munson Healthcare Grayling Texas Health Presbyterian Hospital Allen Texas Health Harris Methodist Hospital Alliance Providence Cedars-Sinai Tarzana Medical Center Providence Holy Cross Medical Center Texas Health Arlington Memorial Hospital Texas Health Harris Methodist Hospital Azle Texas Health Presbyterian Hospital Dallas Texas Health Presbyterian Hospital Denton Texas Health Presbyterian Hospital Flower Mound Texas Health Harris Methodist Hospital Fort Worth Texas Health Hospital Frisco Texas Health Heart & Vascular Hospital Arlington Texas Health Harris Methodist Hospital Hurst-Euless-Bedford Texas Health Presbyterian Hospital Kaufman Providence Little Company of Mary Med Center Torrance Providence Saint John's Health Center Providence Saint Joseph Medical Center Providence St Joseph Hospital Orange Texas Health Presbyterian Hospital Plano Texas Health Hospital Rockwall Texas Health Harris Methodist Hospital Southlake Texas Health Harris Methodist Hospital Southwest Fort Worth Texas Health Specialty Hospital Fort Worth Texas Health Harris Methodist Hospital Stephenville

Code Q4128: frequently asked

What does code Q4128 cost?: Across the published hospital price files, the disclosed cash price for Q4128 ranges from $24.51 to $44,330. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Will this be my final bill?: Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.
What is code Q4128?: Q4128 is the billing code hospitals use to identify "Noncdm Charge Record Medical Supplies" on their published price files. We use it to line up the same service across different hospitals.
Why do prices for this code differ between hospitals?: Each hospital sets its own prices and negotiates separately with each insurer, so the disclosed price for the same code can vary widely from one hospital to another — and even between plans at a single hospital. Comparing the published figures is what this page is for; a difference does not by itself mean one hospital is better or worse.
What this page is not: It is not a quote, a guarantee, or medical advice. It shows what hospitals have published for this code, so you can compare and ask informed questions — your actual cost depends on your insurance, the exact services performed, and the care setting.

All CPT / HCPCS codes Browse hospitals How to read this data