Repair of a superficial wound, 7.6 to 12.5 cm at Avera St. Luke's

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

Repair Lac Simple 7.6-12.5 CM

Aberdeen, SD

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How this price compares nationally

Avera St. Luke's’s median price of $252 is 12% below the median hospital's median price ($287), higher than 43% of the 2,435 hospitals reporting CPT 12004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 12004 at Avera St. Luke's

Negotiated rates from the hospital’s own file: 4 payers, 14 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	Medica com fee schedule · both	$146	$146	—	—	—	$146 – $146
2	Medica ind fee schedule · both	$146	$146	—	—	—	$146 – $146
3	Healthpartners com fee schedule · both	$157	$157	—	—	—	$157 – $157
4	Wellmark ppo fee schedule · both	$159	$159	—	—	—	$159 – $159
5	UnitedHealthcare com fee schedule · both	$200	$200	—	—	—	$200 – $200
6	Healthpartners com percent of total billed charges · outpatientfrom % of charges	$234	$234	—	—	—	$234 – $234
7	Medica ind percent of total billed charges · inpatientfrom % of charges	$270	$270	—	—	—	$270 – $270
8	Medica ind percent of total billed charges · outpatientfrom % of charges	$272	$272	—	—	—	$272 – $272
9	Medica com percent of total billed charges · inpatientfrom % of charges	$318	$318	—	—	—	$318 – $318
10	Medica com percent of total billed charges · outpatientfrom % of charges	$321	$321	—	—	—	$321 – $321
11	UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges	$328	$328	—	—	—	$328 – $328
12	UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges	$328	$328	—	—	—	$328 – $328
13	Wellmark hmo outpatient	$591	$591	—	—	1–10	$591 – $591
14	Wellmark ppo case rate · outpatient	$591	$591	—	—	1–10	$591 – $591

Last updated: Apr 1, 2026

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