Repair of a superficial wound, 7.6 to 12.5 cm

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC RESUPERF WND BODY 7.6-12.5 CM

Payers reporting CPT 12004

Payer pricing summary

Low

$110

Average

$726

Median

$395

High

$7.3k

Payer rate distribution

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#
1	Bcbs Al facility · other · outpatient · +6 other terms	6	$252	$211	$95	45%	38–74	$56 – $322
2	Kaiser fee schedule · outpatient · +25 other terms	105	$265	$391	$595	152%	17–53	$12 – $4.3k
3	Humana fee schedule · outpatient · +33 other terms	384	$203	$358	$776	217%	6–60	$1 – $12.8k
4	Molina fee schedule · outpatient · +33 other terms	198	$210	$236	$176	75%	6–60	$1 – $1.6k
5	UnitedHealthcare fee schedule · outpatient · +42 other terms	558	$235	$637	$1.2k	196%	4–40	$1 – $17.9k
6	Blue Cross Blue Shield fee schedule · outpatient · +38 other terms	476	$288	$742	$1.6k	214%	4–40	$0 – $16.4k
7	Anthem fee schedule · outpatient · +32 other terms	146	$218	$352	$657	187%	3–30	$29 – $6.3k
8	WellCare fee schedule · outpatient · +26 other terms	178	$212	$277	$466	168%	1–10	$30 – $4.3k
9	Caresource fee schedule · outpatient · +18 other terms	66	$309	$364	$479	132%	1–10	$1 – $4.3k
10	Aetna fee schedule · outpatient · +40 other terms	550	$228	$878	$1.9k	212%	—	$1 – $21.3k
11	Cigna fee schedule · outpatient · +37 other terms	258	$221	$794	$1.7k	211%	—	$45 – $11.1k
12	Oscar case rate · outpatient · +22 other terms	129	$2.5k	$2.6k	$805	31%	—	$311 – $7.5k
13	MultiPlan fee schedule · outpatient · +23 other terms	105	$410	$575	$663	115%	—	$45 – $3.5k
14	Devoted facility · fee schedule · outpatient · +18 other terms	103	$192	$315	$708	225%	—	$56 – $4.9k
15	Ambetter facility · fee schedule · outpatient · +21 other terms	97	$342	$521	$1.1k	210%	—	$74 – $8.1k
16	Tricare facility · fee schedule · outpatient · +23 other terms	90	$202	$638	$1.4k	223%	—	$52 – $6.1k
17	Optum fee schedule · outpatient · +28 other terms	72	$182	$291	$288	99%	—	$65 – $1.4k
18	Highmark facility · fee schedule · outpatient · +20 other terms	63	$289	$349	$302	87%	—	$51 – $1.4k
19	Amerihealth Caritas facility · fee schedule · outpatient · +15 other terms	50	$89	$277	$1.1k	380%	—	$49 – $9.5k
20	Medica fee schedule · both · +26 other terms	48	$146	$152	$59	39%	—	$28 – $233
21	Regence professional · fee schedule · outpatient · +20 other terms	44	$99	$153	$109	71%	—	$32 – $417
22	Medicare facility · fee schedule · outpatient · +20 other terms	43	$206	$813	$2.6k	321%	—	$67 – $22k
23	Wellmark fee schedule · both · +24 other terms	40	$141	$133	$32	24%	—	$66 – $226
24	First Health fee schedule · outpatient · +23 other terms	39	$268	$1.2k	$2.1k	168%	—	$83 – $7.2k
25	Healthcare Highways case rate · outpatient · +4 other terms	39	$5.8k	$6.9k	$5.1k	73%	—	$2.1k – $14.6k

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