go back

Washington rates for HCPCS Q4133

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

Facilitymedian $263 · 10th–90th $135$4370%10%20%10th90th$263Professionalmedian $141 · 10th–90th $126$3550%20%40%10th90th$141$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
$151.36 / $380.19 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $141.25 / $602.56
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $141.25
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $134.90
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $323.59 / $562.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $302.00 / $380.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $75.86 / $194.98
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $138.04 / $173.78
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $234.42
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $141.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $125.89 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $134.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $134.90
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $154.88 / $295.12