Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
GRAFT SOFT TISSUE 2X2 CM STRAVIX PL
Low
$0
Average
$689
Median
$179
High
$7.2k
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Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 219 hospitals; the 90th percentile is 16.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Self Regional Healthcare Greenwood, SC | $7.2k | $7.2k | — | — | 25–250 | $680 – $39.9k |
| 2 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Vista, AR | $125 | $131 | $17 | 13% | 20–200 | $125 – $206 |
| 3 | Range Regional Health Services Hibbing, MN | $442 | $442 | — | — | 14 | $88 – $8.1k |
| 4 | Grand Itasca Clinic and Hospital Grand Rapids, MN | $442 | $442 | — | — | 14 | $88 – $4.8k |
| 5 | Mercy Hospital Oklahoma City Inc City, OK | $125 | $139 | $35 | 25% | 7–70 | $118 – $281 |
| 6 | Porter Hospital LLC Valparaiso, IN | $211 | $215 | $54 | 25% | — | $117 – $537 |
| 7 | Victoria of Texas LP Victoria, TX | $180 | $191 | $73 | 38% | — | $102 – $1.6k |
| 8 | Victoria of Texas LP Victoria, TX | $180 | $191 | $73 | 38% | — | $102 – $1.6k |
| 9 | Cocke County HMA, LLC Newport, TN | $136 | $136 | $15 | 11% | — | $119 – $409 |
| 10 | Campbell County HMA, LLC LaFollette, TN | $205 | $4.9k | $8.1k | 167% | — | $78 – $18.9k |
Ask Claude or any MCP client for HCPCS Q4133 pricing at a specific hospital — see how to connect.