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
$642
Median
$130
High
$7.6k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
71 hospitals; the 90th percentile is 45.9× 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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74 hospital rates
iThe hospitals that file a Medicaid 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 | ADVENTIST HEALTH DELANO Delano, CA fee schedule · outpatient | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 2 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $199 | $178 | $31 | 17% | — | $134 – $199 |
| 3 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 4 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 5 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 6 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $88 | $88 | — | — | — | $88 – $88 |
| 7 | Brookings Health System Brookings, SD fee schedule · outpatient | 1 | $1.8k | $2.2k | $1.2k | 54% | — | $668 – $4.0k |
| 8 | Bullhead City Hospital Corporation City, AZ facility · percent of total billed charges · outpatientfrom % of charges | 1 | $387 | $387 | — | — | — | $387 – $387 |
| 9 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 10 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $2.9k | $2.9k | $1.2k | 41% | — | $1.5k – $4.3k |
| 11 | Chapman Global Medical Center Orange, CA facility · fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 12 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $2.2k | $2.2k | $11 | 1% | — | $2.2k – $2.2k |
| 13 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CARMEL CARMEL, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 14 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CRAWFORDSVILLE CRAWFORDSVILLE, IN fee schedule · both | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 15 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN fee schedule · both | 14 | $51 | $53 | $4 | 8% | — | $51 – $61 |
| 16 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN fee schedule · both | 14 | $51 | $53 | $4 | 8% | — | $51 – $61 |
| 17 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN fee schedule · both | 16 | $51 | $53 | $4 | 8% | — | $51 – $61 |
| 18 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE LAFAYETTE, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 19 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 20 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY LAPORTE PORTE, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 21 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 22 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 23 | FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN fee schedule · both | 2 | $56 | $56 | $5 | 9% | — | $51 – $61 |
| 24 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 25 | Geisinger Community Medical Center Scranton, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
← Payers reporting HCPCS Q4133 · Snapshot 20261111T120946Z-9134e7f7