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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Oklahoma 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 Oklahoma, 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 $141 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 5 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 $151
FacilityA hospital or hospital-owned outpatient department$141$141 to $170

How much rates vary

Facilitymedian $141 · 10th to 90th $141 to $331Professionalmedian $135 · 10th to 90th $126 to $174
$100$200$500$1Kfacility $141professional $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
$151.36
Median
$151.36
Typical High
$151.36
Aetna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
BCBS Oklahoma
Setting
Facility
Modifier
None
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Cigna
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$169.82
Typical High
$363.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medica
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$269.15
Medica
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$1,445.44
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$125.89
4 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$15.14
Median
$15.14
Typical High
$15.14

Where Oklahoma 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.

Oklahoma· 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.