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
$173
Average
$195
Median
$189
High
$252
Each hospital's average Bcbs Ks rate, under the methodology and billing class chosen below.
5 hospitals; the 90th percentile is 1.3× 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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5 hospital rates
iThe hospitals that file a Bcbs Ks 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 | The University of Kansas Health System Great Bend Campus Bend, KS fee schedule · both | 1 | $189 | $189 | — | — | 18 | $189 – $189 |
| 2 | COMMONSPIRIT KANSAS, INC. Dodge City, KS fee schedule · outpatient | 2 | $173 | $173 | $49 | 28% | — | $125 – $222 |
| 3 | COMMONSPIRIT KANSAS, INC. Garden City, KS fee schedule · outpatient | 2 | $174 | $174 | $50 | 28% | — | $125 – $224 |
| 4 | COMMONSPIRIT KANSAS, INC. Ulysses, KS fee schedule · outpatient | 1 | $252 | $252 | — | — | — | $252 – $252 |
| 5 | West Central Kansas Association Inc. Russell, KS facility · fee schedule · outpatient | 1 | $189 | $189 | — | — | — | $189 – $189 |
← Payers reporting HCPCS Q4133 · Snapshot 20261111T120946Z-9134e7f7