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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Alaska rates for HCPCS Q4133

Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated October 2026.

How much does Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL cost?

$257

Typical negotiated rate. In Alaska, October 2026.

Insurers have agreed to pay about $257 for this service. The price depends on where it is billed: about $257 from a physician practice, and about $380 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$257$191 to $257
FacilityA hospital or hospital-owned outpatient department$380$257 to $562

How much rates vary

Facilitymedian $380 · 10th to 90th $186 to $933Professionalmedian $257 · 10th to 90th $138 to $339
$100$200$500$1K$2Kfacility $380professional $257

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
Aetna
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$257.04
Typical High
$257.04
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$70.79
Median
$128.82
Typical High
$128.82
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$28.84
Median
$51.29
Typical High
$51.29
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$21.38
Median
$38.90
Typical High
$38.90
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$14.45
Median
$25.70
Typical High
$25.70
Cigna
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$316.23
Typical High
$933.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$371.54
Typical High
$3,235.94
Moda Health
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$257.04
Typical High
$407.38
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$38.90
Median
$38.90
Typical High
$38.90
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$354.81
Median
$398.11
Typical High
$616.60
Premera BCBS
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$281.84
Typical High
$338.84
Providence
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$302.00
Typical High
$933.25
Providence
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$125.89
Typical High
$177.83
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$190.55
Typical High
$354.81

Where Alaska sits

The same service costs 2.2 times more in Alaska than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Alaska· 1st of 51

$257

AK $257NC $117

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.