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South Carolina rates for HCPCS Q4133

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

Facilitymedian $195 · 10th–90th $138–$8,7100%20%10th90th$195Professionalmedian $138 · 10th–90th $126–$1510%50%10th90th$138$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$144.54 / $8,709.64 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $138.04 / $151.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $162.18 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $173.78 / $309.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $125.89 / $134.90