go back

GRAFTJACKET

Nebraska 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?

$83.18

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $83.18 for this service. The price depends on where it is billed: about $83.18 from a physician practice, and about $138 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 6 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$83.18$81.28 to $100
FacilityA hospital or hospital-owned outpatient department$138$100 to $224

How much rates vary

Facilitymedian $138 · 10th to 90th $81 to $2,692Professionalmedian $83 · 10th to 90th $81 to $126
$100$200$500$1K$2K$5Kfacility $138professional $83

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
$81.28
Median
$81.28
Typical High
$128.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$104.71
Typical High
$4,265.80
BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$100.00
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$199.53
Typical High
$229.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$117.49
Typical High
$162.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$120.23
Typical High
$181.97
Medica
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$138.04
Typical High
$151.36
Midlands
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$117.49
Typical High
$173.78
Midlands
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$204.17
Typical High
$309.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$162.18
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$134.90
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$125.89
Typical High
$141.25

Where Nebraska 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.

Nebraska· 45th of 51

$83.18

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.