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Grafix PRIME, GrafixPL PRIME, Stravix and StravixPL

Virginia 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 $155 · 10th–90th $138$3090%20%10th90th$155Professionalmedian $145 · 10th–90th $126$2820%20%40%10th90th$145$2.0$10.0$50.0$200.0

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
$144.54
Typical High
$436.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$194.98
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$398.11
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$173.78
Typical High
$257.04
Medcost
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$151.36
Typical High
$281.84
Medcost
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$138.04
Typical High
$251.19
Sentara
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$162.18
Typical High
$251.19
Sentara
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$162.18
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$147.91