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 SKIN 4X4CM GRAFTJACKET THK.4-.8MM ACELLULAR DERMAL
Covington, GA
See all hospitals reporting HCPCS Q4107 →Price type
Piedmont Newton’s median price of $8.3k is 3729% above the median hospital's median price ($216), higher than 97% 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, 10 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 | Cigna cigna connect percent of total billed charges · bothfrom % of charges | $6.9k | $6.0k | $2.9k | 48% | — | $197 – $8.6k |
| 4 | Cigna cigna percent of total billed charges · bothfrom % of charges | $9.7k | $8.3k | $4.0k | 48% | — | $275 – $12.1k |
| 5 | First Health first health percent of total billed charges · bothfrom % of charges | $10.0k | $8.6k | $4.2k | 48% | — | $284 – $12.4k |
| 6 | Kaiser kaiser percent of total billed charges · bothfrom % of charges | $10.7k | $9.2k | $4.5k | 48% | — | $304 – $13.3k |
| 7 | Beechstreet beechstreet percent of total billed charges · bothfrom % of charges | $12.1k | $10.4k | $5.0k | 48% | — | $344 – $15.1k |
| 8 | MultiPlan multiplan percent of total billed charges · bothfrom % of charges | $12.1k | $10.4k | $5.0k | 48% | — | $344 – $15.1k |
| 9 | Aetna aetna hmo percent of total billed charges · bothfrom % of charges | $11.3k | $10.7k | $2.1k | 20% | — | $7.1k – $13.0k |
| 10 | 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.