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GRAFTJACKET

Oregon 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?

$126

Typical negotiated rate. In Oregon, July 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 $145 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 8 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$126$83.18 to $224
FacilityA hospital or hospital-owned outpatient department$145$120 to $145

How much rates vary

Facilitymedian $145 · 10th to 90th $98 to $145Professionalmedian $126 · 10th to 90th $81 to $275
$100$200facility $145professional $126

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
$117.49
Median
$117.49
Typical High
$117.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$83.18
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$173.78
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$138.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$257.04
Typical High
$323.59
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$109.65
Typical High
$181.97
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$251.19
Typical High
$316.23
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$144.54
Typical High
$144.54
Providence
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$120.23
Typical High
$257.04
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$158.49
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Oregon 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.

Oregon· 2nd of 51

$126

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.