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 STD 4 X 7
Quitman, MS
See all hospitals reporting HCPCS Q4107 →Price type
Rush Medical Foundation’s median price of $3.8k is 1652% above the median hospital's median price ($216), higher than 89% 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: 11 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Humana all payor percent of total billed charges · outpatientfrom % of charges | $2.7k | $2.8k | $419 | 15% | — | $2.4k – $3.6k |
| 2 | Cigna all payor other · outpatient | $3.2k | $3.4k | $499 | 15% | — | $2.8k – $4.3k |
| 3 | Cigna Healthspring all payor other · outpatient | $3.4k | $3.5k | $519 | 15% | — | $2.9k – $4.4k |
| 4 | Humana all payor other · outpatient | $3.4k | $3.5k | $519 | 15% | — | $2.9k – $4.4k |
| 5 | Optum all payor other · outpatient | $3.4k | $3.5k | $519 | 15% | — | $2.9k – $4.4k |
| 6 | UnitedHealthcare all payor other · outpatient | $3.4k | $3.5k | $519 | 15% | — | $2.9k – $4.4k |
| 7 | Ambetter all payor other · outpatient | $3.4k | $3.6k | $525 | 15% | — | $3.0k – $4.5k |
| 8 | Molina all payor other · outpatient | $3.4k | $3.6k | $525 | 15% | — | $3.0k – $4.5k |
| 9 | WellCare all payor other · outpatient | $3.4k | $3.6k | $525 | 15% | — | $3.0k – $4.5k |
| 10 | Aetna all payor percent of total billed charges · outpatientfrom % of charges | $3.8k | $3.9k | $582 | 15% | — | $3.3k – $5.0k |
| 11 | UnitedHealthcare all payor percent of total billed charges · outpatientfrom % of charges | $3.8k | $3.9k | $582 | 15% | — | $3.3k – $5.0k |
| 12 | MultiPlan all payor percent of total billed charges · outpatientfrom % of charges | $4.4k | $4.6k | $672 | 15% | — | $3.8k – $5.7k |
| 13 | Bcbs Ms all payor other · outpatient | $4.7k | $4.9k | $716 | 15% | — | $4.1k – $6.1k |
| 14 | MultiPlan all payor other · inpatient | $4.9k | $5.2k | $761 | 15% | — | $4.3k – $6.5k |
Last updated: Apr 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.