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GRAFTJACKET

Florida 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 Florida, 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 $166 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$83.18 to $126
FacilityA hospital or hospital-owned outpatient department$166$135 to $240

How much rates vary

Facilitymedian $166 · 10th to 90th $120 to $257Professionalmedian $126 · 10th to 90th $81 to $126
$100$200$500$1K$2K$5Kfacility $166professional $126

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
$81.28
Median
$83.18
Typical High
$83.18
Aetna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$83.18
Typical High
$83.18
AvMed
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$107.15
Typical High
$128.82
AvMed
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$107.15
Typical High
$131.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$154.88
Typical High
$275.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Florida Blue
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$239.88
Typical High
$239.88
Florida Blue
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$97.72
Typical High
$123.03
Molina
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$107.15
Typical High
$158.49
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$81.28
Typical High
$123.03

Where Florida sits

The same service costs 1.8 times more in North Dakota than in New Jersey. 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.

Florida· 15th of 51

$126

ND $151NJ $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.