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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Georgia 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?

$138

Typical negotiated rate. In Georgia, October 2026.

Insurers have agreed to pay about $138 for this service. Most negotiated rates run $126 to $138.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $158 · 10th to 90th $126 to $234Professionalmedian $138 · 10th to 90th $107 to $269
$100$200$500facility $158professional $138

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Aetna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$346.74
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$97.72
Median
$138.04
Typical High
$269.15
Cigna
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$158.49
Typical High
$257.04
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$144.54
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$128.82
Typical High
$331.13
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$257.04
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$69.18
Median
$69.18
Typical High
$72.44
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$27.54
Median
$27.54
Typical High
$28.84
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$20.89
Median
$20.89
Typical High
$21.88
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$13.80
Median
$13.80
Typical High
$14.45

Where Georgia 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.

Georgia· 20th of 51

$138

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.