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GRAFTJACKET

Mississippi rates for HCPCS Q4107

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

Rates data updated July 2026.

Facilitymedian $112 · 10th–90th $83$1350%20%10th90th$112Professionalmedian $85 · 10th–90th $81$1260%20%40%10th90th$85$2.0$5.0$10.0$20.0$50.0$100.0$200.0

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
$83.18
Median
$83.18
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$83.18
Typical High
$120.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$112.20
BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$134.90
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$134.90
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$134.90