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Illinois rates for HCPCS Q4133

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

Facilitymedian $240 · 10th–90th $138–$6,3100%10%10th90th$240Professionalmedian $138 · 10th–90th $132–$1740%20%40%10th90th$138$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $295.12 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $218.78 / $602.56
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $162.18
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $194.98 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $154.88