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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Illinois 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 $219 · 10th–90th $138$3800%10%10th90th$219Professionalmedian $138 · 10th–90th $126$1550%50%10th90th$138$100.0$200.0$500.0$1.0K$2.0K

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
$138.04
Median
$245.47
Typical High
$309.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$151.36
BCBS
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$218.78
Typical High
$549.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$128.82
Typical High
$154.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$208.93
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$162.18
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$194.98
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Molina
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$154.88