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Missouri rates for HCPCS Q4133

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

Facilitymedian $182 · 10th–90th $126–$2950%10%10th90th$182Professionalmedian $138 · 10th–90th $110–$1950%20%40%10th90th$138$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $141.25 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $141.25 / $251.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $109.65 / $165.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $147.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $194.98 / $407.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $134.90 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $181.97 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $125.89 / $151.36