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
MATRIX TISSUE 4X4CM GRAFTJACKET NOW THK1-2MM STD ACELLULAR
Augusta, GA
See all hospitals reporting HCPCS Q4107 →Price type
Piedmont Augusta’s median price of $5.5k is 2421% above the median hospital's median price ($216), higher than 92% of the 1,584 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: 10 payers, 12 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare united healthcare fee schedule · both | $248 | $248 | — | — | — | $248 – $248 |
| 2 | UnitedHealthcare united healthcare exchange fee schedule · both | $248 | $248 | — | — | — | $248 – $248 |
| 3 | Bcbs Sc bcbs south carolina exchange percent of total billed charges · bothfrom % of charges | $2.3k | $2.0k | $960 | 48% | — | $72 – $2.9k |
| 4 | Blue Cross Blue Shield blue cross south carolina percent of total billed charges · bothfrom % of charges | $4.5k | $3.8k | $1.9k | 48% | — | $139 – $5.6k |
| 5 | Medcost medcost percent of total billed charges · bothfrom % of charges | $5.7k | $4.9k | $2.4k | 48% | — | $177 – $7.1k |
| 6 | MultiPlan multiplan percent of total billed charges · bothfrom % of charges | $6.3k | $5.4k | $2.6k | 48% | — | $196 – $7.8k |
| 7 | Phcs phcs percent of total billed charges · bothfrom % of charges | $6.3k | $5.4k | $2.6k | 48% | — | $196 – $7.8k |
| 8 | Cigna cigna percent of total billed charges · bothfrom % of charges | $9.7k | $8.3k | $4.0k | 48% | — | $303 – $12.1k |
| 9 | Kaiser kaiser percent of total billed charges · bothfrom % of charges | $10.6k | $9.1k | $4.4k | 48% | — | $330 – $13.2k |
| 10 | First Health first health percent of total billed charges · bothfrom % of charges | $12.1k | $10.4k | $5.0k | 48% | — | $379 – $15.1k |
| 11 | Aetna aetna hmo percent of total billed charges · bothfrom % of charges | $11.3k | $10.7k | $2.1k | 20% | — | $7.1k – $13.0k |
| 12 | Aetna aetna ppo percent of total billed charges · bothfrom % of charges | $11.3k | $10.7k | $2.1k | 20% | — | $7.1k – $13.0k |
Last updated: Jul 1, 2026
See Graftjacket regenerative tissue graft material pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.