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
HC Graftjacket Now Stndrd 4x8cm <32 Sq Cm>
McCall, ID
See all hospitals reporting HCPCS Q4107 →Price type
St Luke's McCall, LTD’s median price of $196 is 9% below the median hospital's median price ($216), higher than 44% 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: 8 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.
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|---|---|---|---|---|---|---|---|
| 1 | Molina hb mccall molina mmcp percent of total billed charges · bothfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
| 2 | Regence hb mccall medicare advantage percent of total billed charges · bothfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
| 3 | Blue Cross Blue Shield hb mccall bci true & secure med adv percent of total billed charges · bothfrom % of charges | $129 | $129 | — | — | — | $129 – $129 |
| 4 | Molina hb mccall molina med adv percent of total billed charges · bothfrom % of charges | $130 | $130 | — | — | — | $130 – $130 |
| 5 | Aetna hb mccall aetna med adv percent of total billed charges · bothfrom % of charges | $140 | $140 | — | — | — | $140 – $140 |
| 6 | Bcbs Id hb mccall bci percent of total billed charges · inpatientfrom % of charges | $194 | $194 | — | — | — | $194 – $194 |
| 7 | Blue Cross Blue Shield hb mccall bci percent of total billed charges · inpatientfrom % of charges | $194 | $194 | — | — | — | $194 – $194 |
| 8 | Aetna hb mccall aetna trinity health (st al's) percent of total billed charges · bothfrom % of charges | $198 | $198 | — | — | — | $198 – $198 |
| 9 | Cigna hb mccall cigna percent of total billed charges · bothfrom % of charges | $205 | $205 | — | — | — | $205 – $205 |
| 10 | Aetna hb mccall bp aetna percent of total billed charges · bothfrom % of charges | $209 | $209 | — | — | — | $209 – $209 |
| 11 | First Health hb mccall first choice health percent of total billed charges · bothfrom % of charges | $209 | $209 | — | — | — | $209 – $209 |
| 12 | UnitedHealthcare hb mccall united healthcare percent of total billed charges · bothfrom % of charges | $211 | $211 | — | — | — | $211 – $211 |
Last updated: Mar 25, 2026
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