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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

North Carolina 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 $182 · 10th–90th $132$6610%10%20%10th90th$182Professionalmedian $132 · 10th–90th $89$1480%20%40%10th90th$132$100.0$200.0$500.0$1.0K$2.0K

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
$131.83
Median
$194.98
Typical High
$660.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$138.04
Typical High
$162.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$120.23
Typical High
$165.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$95.50
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$190.55
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$223.87
Medcost
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$154.88
Typical High
$309.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$208.93
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$151.36
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44