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GRAFTJACKET

Kansas rates for HCPCS Q4107

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

Rates data updated July 2026.

Facilitymedian $98 · 10th–90th $81$1450%20%10th90th$98Professionalmedian $89 · 10th–90th $81$1260%20%10th90th$89$100.0$200.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$85.11
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$89.13
Typical High
$95.50
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$169.82
Typical High
$467.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$100.00
Typical High
$218.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89