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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.

How much does Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL cost?

$138

Typical negotiated rate. In Maryland, July 2026.

Insurers have agreed to pay about $138 for this service. The price depends on where it is billed: about $138 from a physician practice, and about $2,884 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$138$138 to $145
FacilityA hospital or hospital-owned outpatient department$2,884$138 to $2,884

How much rates vary

Facilitymedian $2,884 · 10th to 90th $138 to $3,311Professionalmedian $138 · 10th to 90th $126 to $186
$200$500$1K$2Kfacility $2,884professional $138

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where Maryland sits

The same service costs 1.7 times more in Alaska than in Minnesota. 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.

Maryland· 43rd of 51

$138

AK $219MN $126

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.