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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Missouri 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 $191 · 10th–90th $102$3800%10%10th90th$191Professionalmedian $138 · 10th–90th $110$2240%20%10th90th$138$100.0$200.0$500.0$1.0K

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
$144.54
Typical High
$295.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$141.25
Typical High
$281.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$109.65
Typical High
$165.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$144.54
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$239.88
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$147.91
Medica
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$194.98
Typical High
$407.38
Medica
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$134.90
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$380.19
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$125.89
Typical High
$154.88