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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Tennessee 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 $245 · 10th–90th $135$9120%20%10th90th$245Professionalmedian $138 · 10th–90th $126$2240%50%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
$776.25
Typical High
$912.01
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$151.36
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$275.42
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$186.21
Typical High
$223.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$134.90
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$125.89
Typical High
$125.89