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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

New Jersey 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 October 2026.

How much does Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL cost?

$135

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $457 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$135$126 to $138
FacilityA hospital or hospital-owned outpatient department$457$178 to $15,488

How much rates vary

Facilitymedian $457 · 10th to 90th $138 to $25,704Professionalmedian $135 · 10th to 90th $126 to $138
$200$1K$5K$20K$100Kfacility $457professional $135

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Aetna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$27.54
Median
$27.54
Typical High
$27.54
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$20.89
Median
$20.89
Typical High
$20.89
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$13.80
Median
$13.80
Typical High
$13.80
AmeriHealth
Setting
Facility
Modifier
None
Typical Low
$2,454.71
Median
$6,309.57
Typical High
$97,723.72
Cigna
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$190.55
Typical High
$257.04
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$154.88
Median
$239.88
Typical High
$281.84
Horizon BCBS
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$14,454.40
Typical High
$26,915.35
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$141.25

Where New Jersey sits

The same service costs 2.2 times more in Alaska than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 36th of 51

$135

AK $257NC $117

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.