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GRAFTJACKET

Delaware 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?

$126

Typical negotiated rate. In Delaware, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $186 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$126$85.11 to $126
FacilityA hospital or hospital-owned outpatient department$186$158 to $224

How much rates vary

Facilitymedian $186 · 10th to 90th $129 to $245Professionalmedian $126 · 10th to 90th $85 to $126
$100$200$500facility $186professional $126

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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
$223.87
Aetna
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Cigna
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$173.78
Typical High
$239.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
United
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$125.89
Typical High
$134.90

Where Delaware 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.

Delaware· 8th of 51

$126

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.