HCPCS Q4133
Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products42 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $238 – $13,208 | $1,246 – $6,216 | $3,116 – $15,539 |
| Cascade Valley Hospital | $171 – $11,664 | $1,606 – $9,331 | $2,008 – $11,664 |
| Deaconess Medical Center | $229 – $11,343 | $1,246 – $6,216 | $3,116 – $15,539 |
| EvergreenHealth Medical Center | $96.00 – $363 | $240 | $300 |
| Harborview Medical Center | $231 – $307 | $2,209 – $3,603 | $3,155 – $5,147 |
| Highline Medical Center | $236 – $44,721 | $167 – $15,173 | $548 – $49,690 |
| Island Hospital | $193 – $439 | $462 | $462 |
| Kadlec Regional Medical Center | $172 – $527 | $225 – $13,167 | $322 – $18,810 |
| Legacy Salmon Creek Medical Center | $219 – $307 | — | — |
| Mary Bridge Children's Hospital | $1,000 – $12,649 | $1,246 – $6,216 | $3,116 – $15,539 |
| MultiCare Auburn Medical Center | $239 – $11,343 | $1,246 – $6,216 | $3,116 – $15,539 |
| MultiCare Covington Medical Center | $239 – $11,343 | $1,246 – $6,216 | $3,116 – $15,539 |
| MultiCare Good Samaritan Hospital | $240 – $11,343 | $1,246 – $6,216 | $3,116 – $15,539 |
| MultiCare Valley Hospital | $229 – $11,188 | $1,246 – $6,216 | $3,116 – $15,539 |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $159 – $380 | — | — |
| PeaceHealth Southwest Medical Cente | $50.61 – $410 | $2,187 | $3,365 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $151 – $460 | $1,126 – $16,614 | $1,609 – $23,734 |
| Providence Centralia Hospital | $244 – $875 | $1,733 – $14,976 | $3,332 – $28,800 |
| Providence Holy Family Hospital | $151 – $508 | $1,126 – $16,614 | $1,609 – $23,734 |
| Providence Mount Carmel Hospital | — | $1,073 – $15,939 | $1,533 – $22,770 |
| Providence Regional Medical Center Everett | $151 – $440 | $495 – $21,996 | $952 – $42,300 |
| Providence St Joseph Hospital | — | $1,073 – $15,939 | $1,533 – $22,770 |
| Providence St Mary Medical Center | $222 – $876 | $1,169 – $15,183 | $1,671 – $21,690 |
| Providence St Peter Hospital | $122 – $559 | $1,733 – $14,976 | $3,332 – $28,800 |
| Skagit Valley Hospital | $290 – $11,081 | $1,606 – $9,331 | $2,008 – $11,664 |
| St Anthony Hospital | $395 – $37,267 | $167 – $15,113 | $548 – $49,690 |
| St Clare Hospital | $395 – $37,267 | $158 – $14,323 | $548 – $49,690 |
| St Elizabeth Hospital | $183 – $44,721 | $194 – $17,559 | $548 – $49,690 |
| St Francis Community Hospital | $395 – $37,267 | $172 – $15,594 | $548 – $49,690 |
| St Joseph Medical Center | $395 – $37,267 | $182 – $16,457 | $548 – $49,690 |
| St Michael Medical Center | $282 – $44,721 | $242 – $21,930 | $548 – $49,690 |
| Swedish Edmonds Hospital | $151 – $510 | $1,146 – $17,280 | $2,388 – $36,000 |
| Swedish Issaquah | $151 – $613 | $1,146 – $17,280 | $2,388 – $36,000 |
| Swedish Medical Center | $151 – $611 | $1,146 – $17,280 | $2,388 – $36,000 |
| Swedish Medical Center / Cherry Hill | $151 – $611 | $1,146 – $17,280 | $2,388 – $36,000 |
| Tacoma General Allenmore Hospital | $240 – $11,343 | $1,246 – $6,216 | $3,116 – $15,539 |
| Trios Health | — | — | $8,975 |
| University of Washington Medical Ctr | $231 – $452 | $391 – $3,202 | $558 – $4,575 |
| Virginia Mason Medical Center | $218 – $892 | $186 – $569 | $364 – $1,115 |
| Wellfound Behavioral Health Hospital | $367 | — | — |
| Yakima Valley Memorial | $233 – $353 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Doctor's fee, Seattle (King County)
- $156 in an office; $156 in a hospital or surgery center
- Doctor's fee, rest of Washington
- $134 in an office; $134 in a hospital or surgery center
- Hospital outpatient payment (national)
- $127 (APC 6002)
- Surgery center payment (national)
- $127