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
$119
Average
$648
Median
$395
High
$2.1k
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
69 hospitals; the 90th percentile is 7.0× 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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107 hospital rates
iThe hospitals that file a Medical Mutual 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 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 2 | AnMed Health Anderson, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.1k | $2.1k | $676 | 33% | — | $1.1k – $2.9k |
| 3 | AnMed Health Cannon Pickens, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.1k | $2.1k | $676 | 33% | — | $1.1k – $2.9k |
| 4 | AnMed Piedmont Piedmont, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.1k | $2.1k | $676 | 33% | — | $1.1k – $2.9k |
| 5 | Bay Park Community Hospital Oregon, OH facility · other · outpatient | 1 | $466 | $466 | — | — | — | $466 – $466 |
| 6 | Bay Park Community Hospital Oregon, OH professional · fee schedule · outpatient | 1 | $318 | $318 | — | — | — | $318 – $318 |
| 7 | Beavercreek Medical Center Springfield, OH fee schedule · outpatient | 2 | $247 | $247 | $62 | 25% | — | $185 – $309 |
| 8 | Benefis Hospitals Inc Helena, MT fee schedule · outpatient | 1 | $208 | $208 | — | — | — | $208 – $208 |
| 9 | Benefis Hospitals Inc Helena, MT percent of total billed charges · inpatientfrom % of charges | 1 | $2.7k | $2.7k | $2.5k | 92% | — | $205 – $5.2k |
| 10 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 11 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $150 | $165 | $37 | 22% | — | $106 – $221 |
| 12 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $182 | $176 | $45 | 25% | — | $106 – $263 |
| 13 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $319 | $350 | $78 | 22% | — | $225 – $469 |
| 14 | Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 15 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $387 | $421 | $100 | 24% | — | $273 – $569 |
| 16 | Dayton Osteopathic Hospital Dayton, OH fee schedule · outpatient | 2 | $247 | $247 | $62 | 25% | — | $185 – $309 |
| 17 | Defiance Hospital Inc Defiance, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $483 | $483 | — | — | — | $483 – $483 |
| 18 | Defiance Hospital Inc Defiance, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $483 | $483 | — | — | — | $483 – $483 |
| 19 | Defiance Hospital Inc Defiance, OH professional · fee schedule · outpatient | 1 | $424 | $424 | — | — | — | $424 – $424 |
| 20 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $534 | $1.2k | $1.2k | 101% | — | $242 – $4.1k |
| 21 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 22 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · inpatientfrom % of charges | 2 | $290 | $361 | $213 | 59% | — | $144 – $889 |
| 23 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · outpatientfrom % of charges | 2 | $290 | $361 | $213 | 59% | — | $144 – $889 |
| 24 | Fort Hamilton Hospital Hamilton, OH fee schedule · outpatient | 2 | $247 | $247 | $62 | 25% | — | $185 – $309 |
| 25 | Fostoria Hospital Association Fostoria, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $454 | $454 | — | — | — | $454 – $454 |
← Payers reporting HCPCS Q4133 · Snapshot 20261111T120946Z-9134e7f7