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
PR SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM
Low
$24
Average
$389
Median
$269
High
$3.9k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
257 hospitals; the 90th percentile is 6.4× 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.
Filter by billing methodology
Filter by billing class
567 hospital rates
iThe hospitals that file a Medica 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 | Fairview Health Services Burnsville, MN other · inpatient | 4 | $142 | $135 | $17 | 13% | 12–120 | $106 – $148 |
| 2 | Fairview Health Services Edina, MN other · inpatient | 2 | $115 | $115 | $22 | 20% | 6–60 | $92 – $137 |
| 3 | HealthEast St John's Hospital Maplewood, MN other · inpatient | 2 | $130 | $130 | $37 | 29% | 6–60 | $92 – $167 |
| 4 | Fairview Health Services Burnsville, MN other · outpatient | 2 | $121 | $121 | $15 | 13% | 4–40 | $106 – $136 |
| 5 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $145 | $145 | — | — | 3–30 | $145 – $145 |
| 6 | Fairview Health Services Wyoming, MN other · inpatient | 1 | $124 | $124 | — | — | 3–30 | $124 – $124 |
| 7 | Fairview Health Services Edina, MN other · outpatient | 1 | $92 | $92 | — | — | 2–20 | $92 – $92 |
| 8 | Fairview Health Services Minneapolis, MN other · outpatient | 1 | $145 | $145 | — | — | 2–20 | $145 – $145 |
| 9 | Fairview Health Services Burnsville, MN percent of total billed charges · outpatientfrom % of charges | 1 | $162 | $162 | $0 | 0% | 2–20 | $162 – $162 |
| 10 | Fairview Health Services Wyoming, MN other · outpatient | 1 | $124 | $124 | — | — | 2–20 | $124 – $124 |
| 11 | HealthEast St John's Hospital Maplewood, MN other · outpatient | 1 | $92 | $92 | — | — | 2–20 | $92 – $92 |
| 12 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 8 | $549 | $687 | $238 | 35% | 2–20 | $175 – $1.0k |
| 13 | Mayo Clinic Health System St, NE facility · percent of total billed charges · bothfrom % of charges | 9 | $337 | $430 | $186 | 43% | 2–20 | $154 – $668 |
| 14 | Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges | 3 | $192 | $296 | $170 | 57% | 2–20 | $160 – $536 |
| 15 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 2 | $187 | $187 | $81 | 43% | 1–10 | $106 – $267 |
| 16 | Avera McKennan Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $196 | $196 | $15 | 8% | 1–10 | $181 – $211 |
| 17 | SAINT FRANCIS MEDICAL CENTER Grand Island, NE fee schedule · outpatient | 2 | $302 | $302 | $196 | 65% | 1–10 | $106 – $497 |
| 18 | ALEGENT CREIGHTON HEALTH Papillion, NE case rate · outpatient | 3 | $953 | $816 | $463 | 57% | — | $194 – $1.3k |
| 19 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 2 | $187 | $187 | $81 | 43% | — | $106 – $267 |
| 20 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · inpatient | 4 | $392 | $394 | $92 | 23% | — | $295 – $498 |
| 21 | ALEGENT CREIGHTON HEALTH Plainview, NE fee schedule · outpatient | 5 | $314 | $355 | $125 | 35% | — | $81 – $498 |
| 22 | ALEGENT CREIGHTON HEALTH Omaha, NE case rate · outpatient | 3 | $953 | $816 | $463 | 57% | — | $194 – $1.3k |
| 23 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 4 | $392 | $394 | $92 | 23% | — | $295 – $498 |
| 24 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · outpatient | 5 | $311 | $346 | $131 | 38% | — | $81 – $498 |
| 25 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA case rate · outpatient | 3 | $953 | $816 | $463 | 57% | — | $194 – $1.3k |
← Payers reporting CPT 12013 · Snapshot 20261111T120946Z-9134e7f7