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GRAFTJACKET

Tennessee 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?

$126

Typical negotiated rate. In Tennessee, October 2026.

Insurers have agreed to pay about $126 for this service. Most negotiated rates run $95.50 to $126.

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.

How much rates vary

Facilitymedian $170 · 10th to 90th $145 to $295Professionalmedian $126 · 10th to 90th $83 to $851
$100$200$500$1Kfacility $170professional $126

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
$83.18
Median
$83.18
Typical High
$83.18
Aetna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Cigna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$169.82
Typical High
$295.12
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$851.14
Median
$1,096.48
Typical High
$1,096.48
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$125.89

Where Tennessee 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.

Tennessee· 23rd of 51

$126

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.