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SurGraft

Nebraska rates for HCPCS Q4209

SurGraft, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated October 2026.

How much does SurGraft cost?

$126

Typical negotiated rate. In Nebraska, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $224 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$126 to $347
FacilityA hospital or hospital-owned outpatient department$224$204 to $234

How much rates vary

Facilitymedian $224 · 10th to 90th $191 to $331Professionalmedian $126 · 10th to 90th $120 to $347
$200facility $224professional $126

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
$346.74
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
None
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$173.78
Median
$173.78
Typical High
$173.78
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$34.67
Median
$34.67
Typical High
$34.67
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$223.87
Typical High
$234.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$158.49
Typical High
$190.55
Midlands
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$316.23
Midlands
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$223.87
Typical High
$331.13
Midlands
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$316.23
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$125.89

Where Nebraska sits

The same service costs 2.3 times more in North Dakota than in North Carolina. 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.

Nebraska· 24th of 51

$126

ND $224NC $97.72

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.