Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
GRAFT JACKET NOW 2X12CM 1-2MM STD
Hackensack, NJ
See all hospitals reporting HCPCS Q4107 →Price type
Hmh Hospitals Corporation’s median price of $201 is 7% below the median hospital's median price ($216), higher than 45% of the 1,589 hospitals reporting HCPCS Q4107. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 14 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Clover medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $49 | $387 | $496 | 128% | — | $25 – $1.5k |
| 2 | Optum managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $60 | $473 | $606 | 128% | — | $31 – $1.8k |
| 3 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $81 | $637 | $815 | 128% | — | $42 – $2.4k |
| 4 | Cigna hmo facility · percent of total billed charges · bothfrom % of charges | $93 | $729 | $933 | 128% | — | $48 – $2.8k |
| 5 | Cigna ppo facility · percent of total billed charges · bothfrom % of charges | $93 | $729 | $933 | 128% | — | $48 – $2.8k |
| 6 | Aetna asa facility · percent of total billed charges · outpatientfrom % of charges | $117 | $921 | $1.2k | 128% | — | $61 – $3.5k |
| 7 | Aetna hmo facility · percent of total billed charges · outpatientfrom % of charges | $117 | $921 | $1.2k | 128% | — | $61 – $3.5k |
| 8 | Aetna ppo facility · percent of total billed charges · outpatientfrom % of charges | $117 | $921 | $1.2k | 128% | — | $61 – $3.5k |
| 9 | WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $123 | $968 | $1.2k | 128% | — | $64 – $3.7k |
| 10 | WellCare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $123 | $968 | $1.2k | 128% | — | $64 – $3.7k |
| 11 | Aetna managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $134 | $1.1k | $1.3k | 128% | — | $69 – $4.1k |
| 12 | UnitedHealthcare hmo facility · percent of total billed charges · outpatientfrom % of charges | $155 | $1.2k | $1.6k | 128% | — | $80 – $4.7k |
| 13 | Cigna bh facility · percent of total billed charges · outpatientfrom % of charges | $219 | $1.7k | $2.2k | 128% | — | $113 – $6.6k |
| 14 | MultiPlan all products facility · percent of total billed charges · bothfrom % of charges | $232 | $1.8k | $2.3k | 128% | — | $120 – $7.0k |
Last updated: Dec 31, 2025
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