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
SIMPLE RPR SUPRFCL WND SCLP/NK/AX/GN/TRK/EXT 2.5CM/LS-CAC
Low
$76
Average
$267
Median
$262
High
$558
Each hospital's average Healthpartners rate, under the methodology and billing class chosen below.
104 hospitals; the 90th percentile is 2.8× 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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249 hospital rates
iThe hospitals that file a Healthpartners 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 | Northfield Hospital Northfield, MN percent of total billed charges · bothfrom % of charges | 1 | $444 | $439 | $8 | 2% | 18 | $428 – $444 |
| 2 | Avera McKennan Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 1 | $164 | $150 | $20 | 13% | 13–22 | $122 – $164 |
| 3 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $127 | $280 | $219 | 78% | 3–30 | $124 – $597 |
| 4 | Avera St. Benedicts Parkston, SD percent of total billed charges · outpatientfrom % of charges | 1 | $356 | $356 | — | — | 2–20 | $356 – $356 |
| 5 | Hegg Health Center Rock Valley, IA percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $155 | $25 | 16% | 2–20 | $137 – $190 |
| 6 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 2 | $95 | $183 | $141 | 77% | 2–20 | $75 – $423 |
| 7 | Mayo Clinic Health System St, NE facility · percent of total billed charges · bothfrom % of charges | 2 | $95 | $183 | $141 | 77% | 2–20 | $75 – $423 |
| 8 | Pipestone County Medical Center Pipestone, MN percent of total billed charges · outpatientfrom % of charges | 1 | $219 | $193 | $36 | 19% | 2–20 | $142 – $219 |
| 9 | Sioux Center Health Sioux Center, IA percent of total billed charges · outpatientfrom % of charges | 1 | $111 | $313 | $286 | 91% | 2–20 | $110 – $719 |
| 10 | Avera Marshall Hospital Marshall, MN percent of total billed charges · outpatientfrom % of charges | 1 | $322 | $322 | — | — | 1–10 | $322 – $322 |
| 11 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · outpatientfrom % of charges | 1 | $506 | $427 | $113 | 26% | 1–10 | $267 – $506 |
| 12 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · outpatientfrom % of charges | 1 | $241 | $241 | — | — | 1–10 | $241 – $241 |
| 13 | Avera St. Luke's Aberdeen, SD percent of total billed charges · outpatientfrom % of charges | 1 | $234 | $234 | — | — | 1–10 | $234 – $234 |
| 14 | Avera Tyler Hospital Tyler, MN percent of total billed charges · outpatientfrom % of charges | 1 | $422 | $422 | — | — | 1–10 | $422 – $422 |
| 15 | Grundy County Memorial Hospital Grundy Center, IA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $142 | $142 | — | — | 1–10 | $142 – $142 |
| 16 | Grundy County Memorial Hospital Grundy Center, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $84 | — | — | 1–10 | $84 – $84 |
| 17 | Lakes Regional Hospital Spirit Lake, IA percent of total billed charges · outpatientfrom % of charges | 1 | $690 | $532 | $224 | 42% | 1–10 | $215 – $690 |
| 18 | Landmann-Jungman Hosp Scotland, SD percent of total billed charges · outpatientfrom % of charges | 1 | $307 | $307 | — | — | 1–10 | $307 – $307 |
| 19 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 4 | $498 | $375 | $184 | 49% | 1–10 | $114 – $523 |
| 20 | Mayo Clinic Rochester, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $868 | $868 | — | — | 1–10 | $868 – $868 |
| 21 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $542 | $542 | — | — | 1–10 | $542 – $542 |
| 22 | Mayo Clinic Health System St, NE facility · percent of total billed charges · outpatientfrom % of charges | 1 | $416 | $416 | — | — | 1–10 | $416 – $416 |
| 23 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $558 | $558 | — | — | — | $558 – $558 |
| 24 | Amery Hospital Amery, WI facility · fee schedule · both | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 25 | Aspirus Merrill Hospital Merrill, WI fee schedule · both | 1 | $484 | $484 | — | — | — | $484 – $484 |
← Payers reporting CPT 12001 · Snapshot 20261111T120946Z-9134e7f7