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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 October 2026.

How much does GRAFTJACKET cost?

$126

Typical negotiated rate. In Massachusetts, 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$93.33 to $174
FacilityA hospital or hospital-owned outpatient department$166$105 to $214

How much rates vary

Facilitymedian $166 · 10th to 90th $85 to $269Professionalmedian $126 · 10th to 90th $85 to $302
$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
$85.11
Median
$85.11
Typical High
$239.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$239.88
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$281.84
AllWays Health Partners
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$125.89
Typical High
$851.14
BCBS Massachusetts
Setting
Facility
Modifier
None
Typical Low
$95.50
Median
$109.65
Typical High
$199.53
Cigna
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$229.09
Typical High
$389.05
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$181.97
Typical High
$363.08
Fallon Health
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$199.53
Typical High
$234.42
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$125.89
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$281.84
Mass General Brigham
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$125.89
Typical High
$851.14
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$141.25
Well Sense
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$120.23
Typical High
$177.83
Well Sense
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$91.20
Typical High
$109.65

Where Massachusetts sits

The same service costs 1.8 times more in North Dakota than in Virginia. 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· 16th of 51

$126

ND $151VA $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.