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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

California 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 July 2026.

Facilitymedian $166 · 10th–90th $138$6170%20%40%10th90th$166Professionalmedian $138 · 10th–90th $78$3720%50%10th90th$138$0.1$2.0$50.0$1.0K$20.0K$500.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$602.56
Typical High
$2,754.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$141.25
Typical High
$512.86
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$162.18
Typical High
$213.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$162.18
Typical High
$302.00
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$316.23
Typical High
$316.23
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$218.78
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$162.18
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$162.18
Typical High
$239.88
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$173.78
Typical High
$269.15
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
Molina
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Providence
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$165.96
Typical High
$275.42
Providence
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$173.78
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$302.00
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$162.18
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$223.87