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GRAFTJACKET

New Jersey 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?

$85.11

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $85.11 for this service. The price depends on where it is billed: about $85.11 from a physician practice, and about $257 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$85.11$85.11 to $126
FacilityA hospital or hospital-owned outpatient department$257$145 to $14,454

How much rates vary

Facilitymedian $257 · 10th to 90th $85 to $21,878Professionalmedian $85 · 10th to 90th $85 to $126
$100$500$2K$10Kfacility $257professional $85

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
$85.11
Aetna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$85.11
Typical High
$85.11
Cigna
Setting
Facility
Modifier
None
Typical Low
$102.33
Median
$165.96
Typical High
$257.04
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$165.96
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$14,454.40
Typical High
$27,542.29
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$147.91
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$141.25

Where New Jersey 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.

New Jersey· 50th of 51

$85.11

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.