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GRAFTJACKET

Virginia 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?

$85.11

Typical negotiated rate. In Virginia, July 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 $97.72 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$85.11$81.28 to $100
FacilityA hospital or hospital-owned outpatient department$97.72$85.11 to $126

How much rates vary

Facilitymedian $98 · 10th to 90th $85 to $209Professionalmedian $85 · 10th to 90th $81 to $126
$100$200facility $98professional $85

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
$85.11
Median
$85.11
Typical High
$85.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$85.11
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$151.36
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$138.04
Typical High
$257.04
Medcost
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Medcost
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$100.00
Typical High
$158.49
Medcost
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$100.00
Typical High
$109.65
Sentara
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$95.50
Typical High
$123.03
Sentara
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$95.50
Typical High
$123.03
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$154.88
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Virginia 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.

Virginia· 22nd of 51

$85.11

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.