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GRAFTJACKET

Arkansas rates for HCPCS Q4107

GRAFTJACKET, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated October 2026.

How much does GRAFTJACKET cost?

$100

Typical negotiated rate. In Arkansas, October 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $100 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$100$85.11 to $126
FacilityA hospital or hospital-owned outpatient department$100$97.72 to $100

How much rates vary

Facilitymedian $100 · 10th to 90th $98 to $126Professionalmedian $100 · 10th to 90th $85 to $126
$100$200facility $100professional $100

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$85.11
Typical High
$85.11
BCBS Arkansas
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$100.00
Typical High
$100.00
BCBS Arkansas
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Cigna
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$173.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$128.82

Where Arkansas sits

The same service costs 1.8 times more in North Dakota than in Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Arkansas· 41st of 51

$100

ND $151VA $85.11

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.