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GRAFTJACKET XPRESS Injectable

Pennsylvania 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 Pennsylvania, 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 $1,660 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$759$759 to $1,660
FacilityA hospital or hospital-owned outpatient department$1,660$1,072 to $2,754

How much rates vary

Facilitymedian $1,660 · 10th to 90th $759 to $3,236Professionalmedian $759 · 10th to 90th $759 to $1,995
$500$1K$2K$5K$10K$20K$50Kfacility $1,660professional $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
Facility
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Aetna
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$1,479.11
Median
$1,659.59
Typical High
$5,011.87
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$1,479.11
Median
$1,659.59
Typical High
$1,659.59
Cigna
Setting
Facility
Modifier
None
Typical Low
$758.58
Median
$1,288.25
Typical High
$2,884.03
Cigna
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$933.25
Median
$933.25
Typical High
$1,318.26
Geisinger
Setting
Professional
Modifier
None
Typical Low
$309.03
Median
$309.03
Typical High
$524.81
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$741.31
Typical High
$933.25
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$851.14
Typical High
$1,023.29
United
Setting
Professional
Modifier
None
Typical Low
$1,778.28
Median
$1,995.26
Typical High
$2,137.96

Where Pennsylvania 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.

Pennsylvania· 47th 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.