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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

North Dakota 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 $138 · 10th–90th $135$2290%50%10th90th$138Professionalmedian $138 · 10th–90th $126$1740%20%40%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
$138.04
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$257.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$128.82
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$251.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$138.04
Typical High
$177.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$190.55
Typical High
$251.19
Medica
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$239.88