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
ALLO GRAFIX PRIME1.5X2CM=3SQ
Windom, MN
See all hospitals reporting HCPCS Q4133 →Price type
Windom Area Hospital’s median price of $204 is 22% below the median hospital's median price ($262), higher than 37% of the 1,813 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, 20 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.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Bcbs Mn pmap facility · percent of total billed charges · inpatientfrom % of charges | $156 | $151 | $10 | 7% | — | $125 – $156 |
| 2 | Bcbs Mn pmap facility · percent of total billed charges · outpatientfrom % of charges | $156 | $151 | $10 | 7% | — | $125 – $156 |
| 3 | Blue Cross Blue Shield managed medicaid facility · percent of total billed charges · inpatientfrom % of charges | $156 | $151 | $10 | 7% | — | $125 – $156 |
| 4 | Blue Cross Blue Shield managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $156 | $151 | $10 | 7% | — | $125 – $156 |
| 5 | Aetna medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $180 | $175 | $12 | 7% | — | $145 – $180 |
| 6 | Blue Cross Blue Shield medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $180 | $175 | $12 | 7% | — | $145 – $180 |
| 7 | Humana medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $180 | $175 | $12 | 7% | — | $145 – $180 |
| 8 | Medica medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $180 | $175 | $12 | 7% | — | $145 – $180 |
| 9 | Ucare medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $180 | $175 | $12 | 7% | — | $145 – $180 |
| 10 | UnitedHealthcare medicare replacement facility · percent of total billed charges · outpatientfrom % of charges | $180 | $175 | $12 | 7% | — | $145 – $180 |
| 11 | Medica pmap facility · percent of total billed charges · inpatientfrom % of charges | $204 | $197 | $14 | 7% | — | $164 – $204 |
| 12 | Medica pmap facility · percent of total billed charges · outpatientfrom % of charges | $204 | $197 | $14 | 7% | — | $164 – $204 |
| 13 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $335 | $324 | $22 | 7% | — | $270 – $335 |
| 14 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $335 | $324 | $22 | 7% | — | $270 – $335 |
| 15 | Bcbs Mn commercial facility · percent of total billed charges · outpatientfrom % of charges | $344 | $333 | $23 | 7% | — | $276 – $344 |
| 16 | Bcbs Nd commercial facility · percent of total billed charges · outpatientfrom % of charges | $344 | $333 | $23 | 7% | — | $276 – $344 |
| 17 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $344 | $333 | $23 | 7% | — | $276 – $344 |
| 18 | Wellmark commercial facility · percent of total billed charges · outpatientfrom % of charges | $344 | $333 | $23 | 7% | — | $276 – $344 |
| 19 | Medica commercial facility · percent of total billed charges · inpatientfrom % of charges | $384 | $371 | $26 | 7% | — | $308 – $384 |
| 20 | Medica commercial facility · percent of total billed charges · outpatientfrom % of charges | $384 | $371 | $26 | 7% | — | $308 – $384 |
Last updated: Feb 3, 2026
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