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
TX S WND DEHISC; SMPL [A4]
Low
$12
Average
$1.5k
Median
$947
High
$29.8k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
1820 hospitals; the 90th percentile is 9.4× 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.
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3,274 hospital rates
iThe hospitals that file a Aetna 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 | Carle BroMenn Medical Center Normal, IL percent of total billed charges · outpatientfrom % of charges | 2 | $1.3k | $1.3k | $48 | 4% | 8–80 | $1.3k – $1.3k |
| 2 | The Charlotte Mecklenburg Hospital Authority Huntersville, NC percent of total billed charges · outpatientfrom % of charges | 5 | $217 | $247 | $103 | 42% | 8–80 | $141 – $443 |
| 3 | Northwestern Memorial Hospital Chicago, IL percent of total billed charges · outpatientfrom % of charges | 6 | $2.6k | $5.2k | $6.1k | 117% | 7–70 | $348 – $26.4k |
| 4 | Northwestern Medicine Kishwaukee Hospital DeKalb, IL percent of total billed charges · outpatientfrom % of charges | 6 | $3.1k | $5.8k | $5.3k | 91% | 6–60 | $591 – $16.2k |
| 5 | Palos Community Hospital Palos Heights, IL percent of total billed charges · outpatientfrom % of charges | 4 | $6.2k | $7.6k | $6.3k | 83% | 4–40 | $1.6k – $22.9k |
| 6 | Crouse Hospital Syracuse, NY percent of total billed charges · outpatientfrom % of charges | 2 | $5.3k | $5.3k | — | — | 2–20 | $5.3k – $5.3k |
| 7 | Fairview Health Services Minneapolis, MN percent of total billed charges · bothfrom % of charges | 1 | $822 | $822 | $20 | 2% | 2–20 | $802 – $842 |
| 8 | Hospital for Special Surgery White Plains, NY fee schedule · both | 1 | $560 | $560 | $104 | 19% | 2–20 | $456 – $665 |
| 9 | Hospital for Special Surgery New York, NY fee schedule · both | 1 | $560 | $560 | $104 | 19% | 2–20 | $456 – $665 |
| 10 | Hospital for Special Surgery Water Mill, NY fee schedule · both | 1 | $560 | $560 | $104 | 19% | 2–20 | $456 – $665 |
| 11 | Hospital for Special Surgery New York, NY fee schedule · both | 1 | $560 | $560 | $104 | 19% | 2–20 | $456 – $665 |
| 12 | Hospital for Special Surgery Fresh Meadows, NY fee schedule · both | 1 | $560 | $560 | $104 | 19% | 2–20 | $456 – $665 |
| 13 | Hospital for Special Surgery Brooklyn, NY fee schedule · both | 1 | $560 | $560 | $104 | 19% | 2–20 | $456 – $665 |
| 14 | Hospital for Special Surgery New York, NY fee schedule · both | 1 | $560 | $560 | $104 | 19% | 2–20 | $456 – $665 |
| 15 | Hospital for Special Surgery New York, NY fee schedule · both | 1 | $560 | $560 | $104 | 19% | 2–20 | $456 – $665 |
| 16 | MaineHealth Belfast, ME other · outpatient | 2 | $8.8k | $8.8k | — | — | 2–20 | $8.8k – $8.8k |
| 17 | Adena Health System Chillicothe, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5.6k | $5.6k | — | — | 1–10 | $5.6k – $5.6k |
| 18 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO other · inpatient | 1 | $608 | $608 | — | — | 1–10 | $608 – $608 |
| 19 | Carteret County General Hospital Corporation Morehead City, NC facility · percent of total billed charges · bothfrom % of charges | 1 | $700 | $700 | — | — | 1–10 | $700 – $700 |
| 20 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · percent of total billed charges · outpatientfrom % of charges | 3 | $897 | $1.1k | $315 | 29% | 1–10 | $808 – $1.5k |
| 21 | DIGNITY HEALTH Camarillo, CA fee schedule · outpatient | 1 | $778 | $778 | — | — | 1–10 | $778 – $778 |
| 22 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $485 | $485 | — | — | 1–10 | $485 – $485 |
| 23 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | — | — | 1–10 | $1.1k – $1.1k |
| 24 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $209 | $2.9k | $4.7k | 162% | 1–10 | $171 – $12.6k |
| 25 | MaineHealth Belfast, ME percent of total billed charges · outpatientfrom % of charges | 2 | $388 | $388 | $146 | 38% | 1–10 | $242 – $535 |
← Payers reporting CPT 12020 · Snapshot 20261111T120946Z-9134e7f7