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
HC GRAFIX PRIME PER 1SQ CM Q4133 (HIGH)
Low
$1
Average
$1.2k
Median
$314
High
$16.2k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
875 hospitals; the 90th percentile is 24.5× 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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1,205 hospital rates
iThe hospitals that file a Blue Cross Blue Shield rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | NYU Langone Mineola, NY percent of total billed charges · bothfrom % of charges | 50 | $2.4k | $2.4k | $39 | 2% | 41 | $2.3k – $2.4k |
| 2 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · percent of total billed charges · bothfrom % of charges | 2 | $307 | $338 | $76 | 23% | 40 | $196 – $452 |
| 3 | Samaritan Hospital Troy, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $361 | $1.1k | $1.6k | 150% | 36 | $170 – $5.0k |
| 4 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 2 | $140 | $140 | $20 | 14% | 34–340 | $120 – $160 |
| 5 | Piedmont Atlanta Atlanta, GA percent of total billed charges · bothfrom % of charges | 2 | $7.7k | $7.7k | $6.3k | 82% | 29–128 | $1.4k – $14.0k |
| 6 | PRISMA HEALTH BAPTIST COLUMBIA HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $192 | $192 | $40 | 21% | 27 | $152 – $232 |
| 7 | Self Regional Healthcare Greenwood, SC facility · other · outpatient | 1 | $7.2k | $7.2k | — | — | 25–250 | $7.2k – $7.2k |
| 8 | AnMed Health Anderson, SC facility · percent of total billed charges · outpatientfrom % of charges | 5 | $1.1k | $1.3k | $567 | 45% | 20–200 | $398 – $2.8k |
| 9 | WHITE MEMORIAL MEDICAL CENTER MONTEBELLO, CA percent of total billed charges · outpatientfrom % of charges | 4 | $278 | $1.6k | $1.9k | 116% | 20–200 | $143 – $6.5k |
| 10 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 2 | $140 | $140 | $20 | 14% | 17–170 | $120 – $160 |
| 11 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 2 | $140 | $140 | $20 | 14% | 17–170 | $120 – $160 |
| 12 | SAINT FRANCIS MEDICAL CENTER Grand Island, NE fee schedule · outpatient | 2 | $152 | $152 | $8 | 5% | 13–130 | $144 – $160 |
| 13 | Piedmont Newnan Newnan, GA percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.1k | — | — | 11–110 | $1.1k – $1.1k |
| 14 | DIGNITY HEALTH Phoenix, AZ fee schedule · outpatient | 4 | $741 | $870 | $305 | 35% | 9–90 | $412 – $1.5k |
| 15 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 4 | $549 | $681 | $211 | 31% | 7–70 | $465 – $1.1k |
| 16 | Novant Health Matthews Medical Center LLC Matthews, NC percent of total billed charges · outpatientfrom % of charges | 1 | $2.7k | $2.7k | — | — | 1–10 | $2.7k – $2.7k |
| 17 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $191 | $191 | $40 | 21% | 1–10 | $151 – $230 |
| 18 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC percent of total billed charges · bothfrom % of charges | 2 | $191 | $191 | $40 | 21% | 1–10 | $151 – $230 |
| 19 | ADVENTIST HEALTH DELANO Delano, CA other · outpatient | 2 | $139 | $3.8k | $4.7k | 122% | — | $139 – $11.3k |
| 20 | ADVENTIST HEALTH DELANO Delano, CA percent of total billed charges · outpatientfrom % of charges | 1 | $1.5k | $1.3k | $856 | 66% | — | $174 – $2.2k |
| 21 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA case rate · outpatient | 2 | $1.2k | $1.2k | $61 | 5% | — | $1.1k – $1.2k |
| 22 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 2 | $203 | $203 | $63 | 31% | — | $139 – $266 |
| 23 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA percent of total billed charges · outpatientfrom % of charges | 3 | $3.1k | $3.2k | $1.3k | 42% | — | $1.3k – $5.1k |
| 24 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 2 | $159 | $159 | $20 | 12% | — | $139 – $178 |
| 25 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 3 | $442 | $382 | $139 | 36% | — | $158 – $491 |
← Payers reporting HCPCS Q4133 · Snapshot 20261111T120946Z-9134e7f7