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GRAFTJACKET

Massachusetts 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?

$93.33

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $93.33 for this service. The price depends on where it is billed: about $93.33 from a physician practice, and about $110 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 8 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$93.33$85.11 to $100
FacilityA hospital or hospital-owned outpatient department$110$95.50 to $186

How much rates vary

Facilitymedian $110 · 10th to 90th $85 to $275Professionalmedian $93 · 10th to 90th $83 to $135
$100$200$500$1K$2K$5Kfacility $110professional $93

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
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$85.11
Typical High
$100.00
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$91.20
Typical High
$707.95
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$263.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$190.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$229.09
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$181.97
Typical High
$1,995.26
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$181.97
Typical High
$263.03
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$91.20
Typical High
$707.95
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$263.03
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$100.00
Typical High
$125.89

Where Massachusetts 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.

Massachusetts· 13th of 51

$93.33

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.