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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Texas 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 $158 · 10th–90th $138$7080%20%40%10th90th$158Professionalmedian $141 · 10th–90th $126$1820%50%10th90th$141$2.0$10.0$50.0$200.0$1.0K$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
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$5,248.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$151.36
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,548.13
Typical High
$4,786.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Christus
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$120.23
Typical High
$138.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$302.00
Typical High
$851.14
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
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$141.25
Typical High
$295.12
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$186.21
Typical High
$234.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$134.90
Typical High
$138.04
Providence
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$151.36
Typical High
$295.12
Providence
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$131.83
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$169.82