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
$1
Average
$227
Median
$115
High
$2.0k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
140 hospitals; the 90th percentile is 23.6× 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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179 hospital rates
iThe hospitals that file a Medicaid 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 | IOM Health System LP Fort Wayne, IN facility · other · outpatient | 1 | $648 | $648 | — | — | 1–10 | $648 – $648 |
| 2 | MELROSEWAKEFIELD HEALTHCARE Medford, MA other · both | 1 | $659 | $659 | — | — | 1–10 | $659 – $659 |
| 3 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $659 | $659 | — | — | 1–10 | $659 – $659 |
| 4 | St. Joseph Health System, LLC Wayne, IN facility · other · outpatient | 1 | $648 | $648 | — | — | 1–10 | $648 – $648 |
| 5 | Stephens County Hospital Toccoa, GA other · outpatient | 1 | $171 | $171 | — | — | 1–10 | $171 – $171 |
| 6 | Stephens County Hospital Toccoa, GA percent of total billed charges · outpatientfrom % of charges | 1 | $166 | $166 | — | — | 1–10 | $166 – $166 |
| 7 | Warsaw Health System LLC Warsaw, IN facility · other · outpatient | 1 | $648 | $648 | — | — | 1–10 | $648 – $648 |
| 8 | ACADIAN MEDICAL CENTER EUNICE, LA fee schedule · both | 3 | $483 | $483 | — | — | — | $483 – $483 |
| 9 | ACADIAN MEDICAL CENTER EUNICE, LA percent of total billed charges · bothfrom % of charges | 6 | $136 | $136 | $93 | 68% | — | $43 – $230 |
| 10 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $51 | $51 | $28 | 55% | — | $23 – $79 |
| 11 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $59 | $59 | $21 | 35% | — | $38 – $79 |
| 12 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 13 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $141 | $141 | — | — | — | $141 – $141 |
| 14 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $114 | $114 | — | — | — | $114 – $114 |
| 15 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 2 | $126 | $126 | $6 | 5% | — | $120 – $133 |
| 16 | BETHESDA HOSPITAL BOYNTON BEACH, FL fee schedule · both | 2 | $126 | $126 | $6 | 5% | — | $120 – $133 |
| 17 | Berkshire Medical Center Great Barrington, MA facility · fee schedule · outpatient | 2 | $320 | $320 | — | — | — | $320 – $320 |
| 18 | Brookings Health System Brookings, SD fee schedule · outpatient | 1 | $1.1k | $764 | $454 | 59% | — | $121 – $1.1k |
| 19 | Bullhead City Hospital Corporation City, AZ facility · other · outpatient | 2 | $114 | $114 | $55 | 48% | — | $59 – $169 |
| 20 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 21 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $47 | $47 | — | — | — | $47 – $47 |
| 22 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · inpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 23 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 24 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $140 | $140 | — | — | — | $140 – $140 |
| 25 | Central Community Hospital Elkader, IA professional · fee schedule · inpatient | 1 | $33 | $33 | — | — | — | $33 – $33 |
← Payers reporting CPT 12013 · Snapshot 20261111T120946Z-9134e7f7