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SurgiGRAFT-DUAL

Montana rates for HCPCS Q4219

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

Rates data updated July 2026.

How much does SurgiGRAFT-DUAL cost?

$977

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $977 for this service. Most negotiated rates run $955 to $1,000.

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.

How much rates vary

Facilitymedian $1,023 · 10th to 90th $170 to $1,202Professionalmedian $977 · 10th to 90th $126 to $1,023
$100$200$500$1Kfacility $1,023professional $977

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$977.24
Typical High
$1,023.29
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$204.17
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$181.97
Providence
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$1,023.29
Typical High
$1,202.26
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$1,258.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Montana sits

The same service costs 8.1 times more in Rhode Island 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.

Montana· 15th of 51

$977

RI $1,023NC $126

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.