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GRAFTJACKET XPRESS Injectable

Utah 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 Utah, October 2026.

Insurers have agreed to pay about $759 for this service. Most negotiated rates run $741 to $1,995.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $741 · 10th to 90th $741 to $741Professionalmedian $759 · 10th to 90th $741 to $1,995
$100$200$500$1K$2Kfacility $741professional $759

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Aetna
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Cigna
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$60.26
Typical High
$371.54
Select Health
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Select Health
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$147.91
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$436.52
Typical High
$870.96
United
Setting
Professional
Modifier
None
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26

Where Utah 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.

Utah· 32nd 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.