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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Michigan 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?

$145

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $145 for this service. The price depends on where it is billed: about $145 from a physician practice, and about $316 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$145$126 to $145
FacilityA hospital or hospital-owned outpatient department$316$282 to $468

How much rates vary

Facilitymedian $316 · 10th to 90th $263 to $724Professionalmedian $145 · 10th to 90th $126 to $174
$50$100$200$500$1Kfacility $316professional $145

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
$144.54
Median
$144.54
Typical High
$144.54
Aetna
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$70.79
Median
$70.79
Typical High
$72.44
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$21.38
Median
$21.38
Typical High
$21.88
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$14.45
Median
$14.45
Typical High
$14.45
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$281.84
Median
$323.59
Typical High
$724.44
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$125.89
Typical High
$125.89
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$144.54
Typical High
$144.54
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$199.53
Typical High
$407.38
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$144.54
Typical High
$181.97
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$21.38
Median
$21.38
Typical High
$21.38
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$14.45
Median
$14.45
Typical High
$14.45
Priority Health
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$144.54
Typical High
$144.54
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$134.90

Where Michigan 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.

Michigan· 11th of 51

$145

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.