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GRAFTJACKET

Georgia rates for HCPCS Q4107

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

Rates data updated July 2026.

How much does GRAFTJACKET cost?

$85.11

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $129 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$85.11$83.18 to $126
FacilityA hospital or hospital-owned outpatient department$129$83.18 to $245

How much rates vary

Facilitymedian $129 · 10th to 90th $83 to $339Professionalmedian $85 · 10th to 90th $81 to $129
$100$200facility $129professional $85

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$83.18
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$128.82
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$234.42
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$144.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$128.82
Typical High
$257.04
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$245.47
Typical High
$346.74
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$141.25

Where Georgia sits

The same service costs 1.7 times more in Alaska than in New Mexico. 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.

Georgia· 21st of 51

$85.11

AK $138NM $83.18

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.