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 RESUPERF WND BODY 7.6-12.5 CM
Low
$36
Average
$285
Median
$223
High
$1.6k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
101 hospitals; the 90th percentile is 5.3× 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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231 hospital rates
iThe hospitals that file a Wellmark 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 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $496 | $496 | — | — | 24 | $496 – $496 |
| 2 | Pella Regional Health Center Pella, IA other · outpatient | 1 | $279 | $279 | — | — | 4–40 | $279 – $279 |
| 3 | Avera Holy Family Hospital Estherville, IA case rate · outpatient | 2 | $393 | $393 | — | — | 2–20 | $393 – $393 |
| 4 | Avera Merrill Pioneer Rock Rapids, IA case rate · outpatient | 2 | $134 | $134 | — | — | 2–20 | $134 – $134 |
| 5 | Lakes Regional Hospital Spirit Lake, IA case rate · outpatient | 2 | $658 | $658 | — | — | 2–20 | $658 – $658 |
| 6 | Monument Health Network Inc Deadwood, SD percent of total billed charges · outpatientfrom % of charges | 2 | $405 | $405 | $191 | 47% | 2–20 | $213 – $596 |
| 7 | Sioux Center Health Sioux Center, IA case rate · outpatient | 2 | $65 | $65 | — | — | 2–20 | $65 – $65 |
| 8 | Avera Creighton Hospital Creighton, NE outpatient | 1 | $530 | $530 | — | — | 1–10 | $530 – $530 |
| 9 | Avera Creighton Hospital Creighton, NE percent of total billed charges · outpatientfrom % of charges | 1 | $498 | $498 | — | — | 1–10 | $498 – $498 |
| 10 | Avera Dell Rapids Hospital Dell Rapids, SD outpatient | 1 | $339 | $339 | — | — | 1–10 | $339 – $339 |
| 11 | Avera Dell Rapids Hospital Dell Rapids, SD percent of total billed charges · outpatientfrom % of charges | 1 | $347 | $347 | — | — | 1–10 | $347 – $347 |
| 12 | Avera Hand County Hospital Miller, SD outpatient | 1 | $57 | $57 | — | — | 1–10 | $57 – $57 |
| 13 | Avera Hand County Hospital Miller, SD percent of total billed charges · outpatientfrom % of charges | 1 | $625 | $625 | — | — | 1–10 | $625 – $625 |
| 14 | Avera Queen of Peace Mitchell, SD outpatient | 1 | $727 | $727 | — | — | 1–10 | $727 – $727 |
| 15 | Avera Queen of Peace Mitchell, SD case rate · outpatient | 1 | $727 | $727 | — | — | 1–10 | $727 – $727 |
| 16 | Avera Sacred Heart Hospital Yankton, SD outpatient | 1 | $339 | $339 | — | — | 1–10 | $339 – $339 |
| 17 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · outpatientfrom % of charges | 1 | $469 | $469 | — | — | 1–10 | $469 – $469 |
| 18 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $591 | $591 | — | — | 1–10 | $591 – $591 |
| 19 | Avera St. Luke's Aberdeen, SD case rate · outpatient | 1 | $591 | $591 | — | — | 1–10 | $591 – $591 |
| 20 | Avera St. Mary's Hospital Pierre, SD outpatient | 1 | $164 | $164 | — | — | 1–10 | $164 – $164 |
| 21 | Avera St. Mary's Hospital Pierre, SD case rate · outpatient | 1 | $164 | $164 | — | — | 1–10 | $164 – $164 |
| 22 | Grundy County Memorial Hospital Grundy Center, IA facility · other · outpatient | 1 | $597 | $597 | — | — | 1–10 | $597 – $597 |
| 23 | Sanford Aberdeen Medical Center Aberdeen, SD other · outpatient | 1 | $411 | $411 | — | — | 1–10 | $411 – $411 |
| 24 | Sanford Sheldon Medical Center Sheldon, IA other · outpatient | 1 | $376 | $376 | — | — | 1–10 | $376 – $376 |
| 25 | Sanford USD Medical Center Sioux Falls, SD other · outpatient | 1 | $221 | $221 | — | — | 1–10 | $221 – $221 |
← Payers reporting CPT 12004 · Snapshot 20261111T120946Z-9134e7f7