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GRAFTJACKET XPRESS Injectable

Arizona rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Rates data updated October 2026.

How much does GRAFTJACKET XPRESS Injectable cost?

$759

Typical negotiated rate. In Arizona, October 2026.

Insurers have agreed to pay about $759 for this service. The price depends on where it is billed: about $759 from a physician practice, and about $166 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$759$724 to $1,995
FacilityA hospital or hospital-owned outpatient department$166$67.61 to $339

How much rates vary

Facilitymedian $166 · 10th to 90th $49 to $1,202Professionalmedian $759 · 10th to 90th $107 to $1,995
$50$100$200$500$1K$2Kfacility $166professional $759

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
Professional
Modifier
None
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$48.98
Median
$117.49
Typical High
$309.03
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$100.00
Typical High
$223.87
Cigna
Setting
Facility
Modifier
None
Typical Low
$954.99
Median
$1,348.96
Typical High
$1,412.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Medica
Setting
Facility
Modifier
None
Typical Low
$724.44
Median
$794.33
Typical High
$1,122.02
Medica
Setting
Professional
Modifier
None
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$3,388.44
United
Setting
Professional
Modifier
None
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26

Where Arizona sits

The same service costs 4.2 times more in Oklahoma than in Missouri. 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.

Arizona· 33rd of 51

$759

OK $1,995MO $479

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.