go back

New Hampshire rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Facilitymedian $912 · 10th–90th $759–$1,5140%20%40%10th90th$912Professionalmedian $776 · 10th–90th $741–$1,4790%20%40%10th90th$776$200.0$500.0$1.0K$2.0K$5.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $758.58 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $758.58 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,513.56 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $954.99 / $1,995.26
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,096.48 / $1,230.27