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GRAFTJACKET XPRESS Injectable

South Dakota rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Rates data updated July 2026.

Facilitymedian $1,000 · 10th–90th $813$1,2300%20%40%10th90th$1,000Professionalmedian $891 · 10th–90th $759$1,9950%20%10th90th$891$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
$724.44
Median
$891.25
Typical High
$891.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$776.25
Typical High
$891.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$1,096.48
Typical High
$1,380.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$1,023.29
Medica
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$1,148.15
Typical High
$1,513.56
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,905.46
Median
$1,995.26
Typical High
$3,388.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,230.27
Typical High
$1,230.27
Midlands
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$645.65
Midlands
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$1,071.52
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$933.25
United
Setting
Professional
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$2,290.87
Wellmark
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00