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GRAFTJACKET XPRESS Injectable

New Hampshire rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Rates data updated July 2026.

Facilitymedian $871 · 10th–90th $759$2,0420%20%40%10th90th$871Professionalmedian $912 · 10th–90th $759$1,4790%20%40%10th90th$912$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
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$912.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$758.58
Typical High
$912.01
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$758.58
Typical High
$870.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,513.56
Typical High
$2,089.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$1,698.24
United
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$954.99
Typical High
$1,995.26
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$1,096.48
Typical High
$1,230.27