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GRAFTJACKET XPRESS Injectable

Ohio rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Rates data updated July 2026.

Facilitymedian $724 · 10th–90th $724$2,4550%50%90th$724Professionalmedian $759 · 10th–90th $724$1,7380%50%10th90th$759$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$724.44
Median
$724.44
Typical High
$724.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$741.31
Typical High
$758.58
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,047.13
Typical High
$1,584.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,621.81
Typical High
$2,187.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$870.96
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,621.81
Typical High
$2,344.23
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$1,047.13
Typical High
$1,513.56
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$75.86
Typical High
$1,949.84
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$4,265.80
Typical High
$4,265.80
United
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$1,995.26
Typical High
$1,995.26