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GRAFTJACKET XPRESS Injectable

Wisconsin rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Rates data updated October 2026.

How much does GRAFTJACKET XPRESS Injectable cost?

$1,349

Typical negotiated rate. In Wisconsin, October 2026.

Insurers have agreed to pay about $1,349 for this service. The price depends on where it is billed: about $1,349 from a physician practice, and about $1,175 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 10 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,349$759 to $1,995
FacilityA hospital or hospital-owned outpatient department$1,175$912 to $2,344

How much rates vary

Facilitymedian $1,175 · 10th to 90th $724 to $2,344Professionalmedian $1,349 · 10th to 90th $724 to $2,754
$1K$2Kfacility $1,175professional $1,349

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
$724.44
Median
$724.44
Typical High
$724.44
Aetna
Setting
Professional
Modifier
None
Typical Low
$724.44
Median
$724.44
Typical High
$2,754.23
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$660.69
Median
$1,348.96
Typical High
$1,348.96
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$2,238.72
Typical High
$2,630.27
Cigna
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$2,290.87
DeanCare
Setting
Facility
Modifier
None
Typical Low
$691.83
Median
$912.01
Typical High
$912.01
DeanCare
Setting
Professional
Modifier
None
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Medica
Setting
Facility
Modifier
None
Typical Low
$691.83
Median
$891.25
Typical High
$912.01
Medica
Setting
Professional
Modifier
None
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$3,388.44
Network Health
Setting
Facility
Modifier
None
Typical Low
$2,137.96
Median
$2,137.96
Typical High
$2,137.96
Network Health
Setting
Professional
Modifier
None
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$1,862.09
Prevea360
Setting
Facility
Modifier
None
Typical Low
$691.83
Median
$912.01
Typical High
$912.01
Quartz
Setting
Professional
Modifier
None
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Quartz
Setting
Facility
Modifier
None
Typical Low
$1,023.29
Median
$2,344.23
Typical High
$2,344.23
Quartz
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Security Health
Setting
Professional
Modifier
None
Typical Low
$812.83
Median
$1,230.27
Typical High
$1,258.93
United
Setting
Professional
Modifier
None
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$2,754.23

Where Wisconsin 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.

Wisconsin· 6th of 51

$1,349

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.