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
GRAFIX P 5X5CM 2087X-2714
Merced, CA
See all hospitals reporting HCPCS Q4133 →Price type
Dignity Health’s median price of $296 is 13% above the median hospital's median price ($263), higher than 57% of the 1,811 hospitals reporting HCPCS Q4133. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 28 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Kaiser medicaid|< 21 fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 2 | Kaiser medicaid|> 21 fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 3 | Molina medicaid|< 21 fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 4 | Molina medicaid|> 21 fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 5 | Anthem medicaid|< 21 fee schedule · outpatient | $154 | $154 | — | — | — | $154 – $154 |
| 6 | Anthem medicaid|> 21 fee schedule · outpatient | $154 | $154 | — | — | — | $154 – $154 |
| 7 | UnitedHealthcare commercial|non-options ppo fee schedule · outpatient | $221 | $221 | — | — | — | $221 – $221 |
| 8 | Anthem commercial|exchange fee schedule · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 9 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $229 | $229 | — | — | — | $229 – $229 |
| 10 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $229 | $229 | — | — | — | $229 – $229 |
| 11 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $229 | $229 | — | — | — | $229 – $229 |
| 12 | Anthem commercial|all other plans fee schedule · outpatient | $296 | $296 | — | — | — | $296 – $296 |
| 13 | Anthem commercial|mcs fee schedule · outpatient | $467 | $467 | — | — | — | $467 – $467 |
| 14 | Cigna commercial|all other plans fee schedule · inpatient | $2.8k | $5.4k | $5.2k | 97% | — | $495 – $15.1k |
| 15 | Cigna commercial|all other plans fee schedule · outpatient | $2.8k | $5.4k | $5.2k | 97% | — | $495 – $15.1k |
| 16 | Cigna commercial|ppo fee schedule · inpatient | $2.8k | $5.4k | $5.2k | 97% | — | $495 – $15.1k |
| 17 | Cigna commercial|ppo fee schedule · outpatient | $2.8k | $5.4k | $5.2k | 97% | — | $495 – $15.1k |
| 18 | Kaiser commercial|all plans fee schedule · inpatient | $2.9k | $5.7k | $5.5k | 97% | — | $526 – $16.1k |
| 19 | Kaiser commercial|all plans fee schedule · outpatient | $2.9k | $5.7k | $5.5k | 97% | — | $526 – $16.1k |
| 20 | First Health commercial|all plans fee schedule · inpatient | $3.4k | $6.6k | $6.4k | 97% | — | $610 – $18.6k |
| 21 | First Health commercial|all plans fee schedule · outpatient | $3.4k | $6.6k | $6.4k | 97% | — | $610 – $18.6k |
| 22 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $3.7k | $7.2k | $7.0k | 97% | — | $663 – $20.3k |
| 23 | Blue Cross Blue Shield commercial|all other plans fee schedule · inpatient | $3.7k | $7.3k | $7.0k | 97% | — | $671 – $20.5k |
| 24 | MultiPlan commercial|all plans fee schedule · inpatient | $4.0k | $7.8k | $7.5k | 97% | — | $716 – $21.9k |
| 25 | MultiPlan commercial|all plans fee schedule · outpatient | $4.0k | $7.8k | $7.5k | 97% | — | $716 – $21.9k |
Last updated: Feb 28, 2026
See Grafix Prime wound care tissue graft pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.