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GRAFTJACKET XPRESS Injectable

Washington rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Rates data updated July 2026.

Facilitymedian $912 · 10th–90th $479$1,5140%20%10th90th$912Professionalmedian $759 · 10th–90th $724$1,6220%50%10th90th$759$50.0$200.0$1.0K$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
$758.58
Median
$758.58
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$741.31
Typical High
$758.58
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,479.11
Typical High
$1,513.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$1,000.00
Typical High
$1,621.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$1,047.13
Typical High
$1,621.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$75.86
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$416.87
Typical High
$758.58
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,995.26
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44