go back

Illinois rates for HCPCS Q4107

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

Facilitymedian $204 · 10th–90th $102–$1,6600%10%10th90th$204Professionalmedian $83 · 10th–90th $79–$1260%50%10th90th$83$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $138.04 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $83.18 / $100.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $218.78 / $398.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $125.89 / $125.89
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $125.89 / $138.04