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GRAFTJACKET

Nevada rates for HCPCS Q4107

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

Rates data updated July 2026.

Facilitymedian $83 · 10th–90th $83$1450%50%90th$83Professionalmedian $83 · 10th–90th $81$1260%50%10th90th$83$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
$83.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$83.18
Typical High
$85.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$93.33
Typical High
$95.50
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$173.78
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$128.82
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Select Health
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$128.82
Typical High
$128.82
Select Health
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$131.83
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$147.91