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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Maryland 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 $2,884 · 10th–90th $138$3,3110%20%10th90th$2,884Professionalmedian $138 · 10th–90th $126$1860%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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$2,884.03
Typical High
$3,311.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$151.36
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$144.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$186.21
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$154.88
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$162.18
Typical High
$204.17