Complex repair of scalp, arm or leg wound, 5 cm or less extra

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

HB Cmplx Rpr S/a/L Addl 5 Cm/>

Payers reporting CPT 13122

Payer pricing summary

Low

Average

$822

Median

$528

High

$5.8k

Payer rate distribution

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#
1	UnitedHealthcare case rate · outpatient · +40 other terms	394	$1.7k	$1.8k	$1.6k	89%	19–190	$1 – $22.4k
2	Aetna case rate · outpatient · +37 other terms	266	$2.3k	$2.8k	$1.6k	58%	4–40	$113 – $16.8k
3	Cigna fee schedule · outpatient · +33 other terms	156	$139	$1.9k	$3.1k	162%	4–40	$67 – $20.7k
4	Kaiser fee schedule · outpatient · +23 other terms	49	$101	$146	$184	126%	2–20	$1 – $1.0k
5	Blue Cross Blue Shield fee schedule · outpatient · +37 other terms	184	$257	$1.5k	$2.8k	185%	1–10	$0 – $18.0k
6	Humana fee schedule · outpatient · +30 other terms	149	$125	$408	$1.2k	293%	1–10	$1 – $12.8k
7	Optum professional · fee schedule · outpatient · +21 other terms	36	$95	$94	$32	34%	1–10	$40 – $132
8	Medicare professional · fee schedule · outpatient · +17 other terms	21	$74	$98	$29	29%	1–10	$61 – $131
9	Oscar case rate · outpatient · +22 other terms	128	$2.6k	$2.6k	$688	27%	—	$990 – $7.5k
10	Anthem fee schedule · outpatient · +27 other terms	112	$114	$255	$334	131%	—	$19 – $3.0k
11	Molina fee schedule · outpatient · +34 other terms	99	$114	$249	$311	125%	—	$1 – $2.0k
12	MultiPlan fee schedule · outpatient · +23 other terms	78	$519	$577	$796	138%	—	$50 – $7.3k
13	Medica fee schedule · outpatient · +22 other terms	44	$243	$279	$163	58%	—	$31 – $731
14	Healthcare Highways case rate · outpatient · +3 other terms	39	$5.8k	$8.2k	$5.3k	65%	—	$2.1k – $14.6k
15	Highmark facility · fee schedule · outpatient · +16 other terms	39	$591	$728	$816	112%	—	$5 – $4.0k
16	WellCare fee schedule · both · +22 other terms	39	$74	$124	$72	58%	—	$61 – $287
17	Superior Healthplan case rate · outpatient · +6 other terms	33	$948	$944	$8	1%	—	$929 – $948
18	Amerihealth Caritas case rate · outpatient · +14 other terms	32	$567	$1.7k	$1.3k	76%	—	$295 – $3.3k
19	Regence professional · fee schedule · outpatient · +17 other terms	32	$102	$121	$44	36%	—	$61 – $317
20	Medicaid facility · fee schedule · outpatient · +12 other terms	31	$784	$1.0k	$1.1k	110%	—	$73 – $3.4k
21	Phcs fee schedule · outpatient · +16 other terms	31	$459	$1.4k	$1.5k	112%	—	$167 – $4.1k
22	Caresource fee schedule · outpatient · +15 other terms	27	$512	$804	$793	99%	—	$1 – $1.9k
23	Tricare facility · fee schedule · outpatient · +19 other terms	27	$648	$6.5k	$16.1k	247%	—	$54 – $50k
24	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	26	$530	$416	$125	30%	—	$111 – $573
25	Ucare professional · fee schedule · outpatient · +14 other terms	24	$90	$91	$30	33%	—	$43 – $144

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