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
Rpr s/n/ax/gen/trk7.6-12.5cm
Conway, SC
See all hospitals reporting CPT 12004 →Price type
Conway Hospital, Inc.’s median price of $121 is 58% below the median hospital's median price ($287), higher than 5% 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: 9 payers, 37 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 | Aetna commercial professional · fee schedule · outpatient | $42 | $42 | $35 | 85% | — | $6 – $77 |
| 2 | Aetna medicare facility · percent of total billed charges · outpatientfrom % of charges | $82 | $66 | $22 | 33% | — | $36 – $82 |
| 3 | Aetna medicare professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 4 | Blue Cross Blue Shield medicare professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 5 | Clover medicare professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 6 | Humana commercial professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 7 | Humana medicare professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 8 | Molina exchange professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 9 | Molina medicare professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 10 | UnitedHealthcare medicare professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 11 | WellCare medicare professional · fee schedule · outpatient | $94 | $94 | $27 | 28% | — | $68 – $121 |
| 12 | Blue Cross Blue Shield narrow network facility · percent of total billed charges · inpatientfrom % of charges | $121 | $99 | $32 | 33% | — | $53 – $121 |
| 13 | Blue Cross Blue Shield narrow network facility · percent of total billed charges · outpatientfrom % of charges | $121 | $99 | $32 | 33% | — | $53 – $121 |
| 14 | Blue Cross Blue Shield exchange facility · percent of total billed charges · inpatientfrom % of charges | $137 | $111 | $36 | 33% | — | $60 – $137 |
| 15 | Blue Cross Blue Shield exchange facility · percent of total billed charges · outpatientfrom % of charges | $137 | $111 | $36 | 33% | — | $60 – $137 |
| 16 | Blue Cross Blue Shield state health plan professional · fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 17 | Blue Cross Blue Shield state health plan facility · percent of total billed charges · inpatientfrom % of charges | $227 | $184 | $60 | 33% | — | $99 – $227 |
| 18 | Blue Cross Blue Shield state health plan facility · percent of total billed charges · outpatientfrom % of charges | $227 | $184 | $60 | 33% | — | $99 – $227 |
| 19 | Aetna medicare facility · case rate · outpatient | $185 | $185 | — | — | — | $185 – $185 |
| 20 | Blue Cross Blue Shield medicare facility · case rate · outpatient | $185 | $185 | — | — | — | $185 – $185 |
| 21 | Clover medicare facility · case rate · outpatient | $185 | $185 | — | — | — | $185 – $185 |
| 22 | Humana commercial facility · case rate · outpatient | $185 | $185 | — | — | — | $185 – $185 |
| 23 | Humana medicare facility · case rate · outpatient | $185 | $185 | — | — | — | $185 – $185 |
| 24 | Molina exchange facility · case rate · outpatient | $185 | $185 | — | — | — | $185 – $185 |
| 25 | Molina medicare facility · case rate · outpatient | $185 | $185 | — | — | — | $185 – $185 |
Last updated: May 20, 2026
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.