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
REPAIR SMP SCL/TRNK/EXT 7.6-12.5CM
Chicago, IL
See all hospitals reporting CPT 12004 →Price type
Advocate Trinity Hospital’s median price of $639 is 123% above the median hospital's median price ($287), higher than 81% of the 2,435 hospitals reporting CPT 12004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 12 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Ambetter medicare advantage case rate · outpatient | $300 | $300 | — | — | — | $300 – $300 |
| 2 | Molina medicare advantage case rate · outpatient | $300 | $300 | — | — | — | $300 – $300 |
| 3 | Oscar medicare advantage case rate · outpatient | $311 | $311 | — | — | — | $311 – $311 |
| 4 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $515 | $515 | — | — | — | $515 – $515 |
| 5 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $534 | $534 | — | — | — | $534 – $534 |
| 6 | UnitedHealthcare commercial other · outpatient | $678 | $678 | — | — | 1–10 | $678 – $678 |
| 7 | Blue Cross Blue Shield commercial percent of total billed charges · outpatientfrom % of charges | $691 | $691 | $27 | 4% | — | $663 – $718 |
| 8 | Blue Cross Blue Shield managed care percent of total billed charges · outpatientfrom % of charges | $698 | $698 | — | — | — | $698 – $698 |
| 9 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $711 | $711 | — | — | — | $711 – $711 |
| 10 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $755 | $755 | — | — | — | $755 – $755 |
| 11 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $792 | $792 | — | — | — | $792 – $792 |
| 12 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $792 | $792 | — | — | — | $792 – $792 |
Last updated: Nov 4, 2025
See Repair of a superficial wound, 7.6 to 12.5 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.