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GRAFTJACKET XPRESS Injectable

Pennsylvania rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Rates data updated July 2026.

How much does GRAFTJACKET XPRESS Injectable cost?

$759

Typical negotiated rate. In Pennsylvania, July 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 $759 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$759$741 to $759
FacilityA hospital or hospital-owned outpatient department$759$759 to $1,514

How much rates vary

Facilitymedian $759 · 10th to 90th $759 to $2,692Professionalmedian $759 · 10th to 90th $724 to $1,660
$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$50.0Kfacility $759professional $759

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,288.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$758.58
Typical High
$758.58
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$1,659.59
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$2,691.53
Typical High
$2,884.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$933.25
Typical High
$954.99
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$467.74
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,288.25
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$758.58
Typical High
$758.58
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,000.00
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,995.26
Typical High
$2,187.76

Where Pennsylvania sits

Rates are fairly even across states for this service. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $759 · 15th of 51
MN $933MO $724

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.