go back

Minnesota rates for HCPCS Q4133

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

Facilitymedian $275 · 10th–90th $135–$4680%20%10th90th$275Professionalmedian $126 · 10th–90th $107–$1410%50%10th90th$126$0.2$1.0$5.0$20.0$100.0$500.0

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 / $138.04 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $177.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $275.42 / $275.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $114.82 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $407.38 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $151.36 / $177.83
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $407.38 / $524.81
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $147.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $302.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $263.03