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
Los Angeles, CA
See all hospitals reporting CPT 12004 →Price type
Dignity Community Care’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.
Negotiated rates from the hospital’s own file: 6 payers, 16 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Kaiser medicaid|< 21 fee schedule · outpatient | $145 | $145 | — | — | — | $145 – $145 |
| 2 | Kaiser medicaid|> 21 fee schedule · outpatient | $145 | $145 | — | — | — | $145 – $145 |
| 3 | Anthem medicaid|all plans fee schedule · outpatient | $151 | $151 | — | — | 1–10 | $151 – $151 |
| 4 | Molina medicaid|< 21 fee schedule · outpatient | $213 | $213 | — | — | — | $213 – $213 |
| 5 | Molina medicaid|> 21 fee schedule · outpatient | $213 | $213 | — | — | — | $213 – $213 |
| 6 | Aetna medicare|all plans fee schedule · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 7 | Anthem medicare|all plans fee schedule · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 8 | Blue Cross Blue Shield medicare|all other plans case rate · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 9 | Molina medicare|all plans fee schedule · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 10 | UnitedHealthcare medicare|all plans case rate · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 11 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $761 | $761 | — | — | — | $761 – $761 |
| 12 | Blue Cross Blue Shield commercial|exchange case rate · outpatient | $855 | $855 | — | — | — | $855 – $855 |
| 13 | Kaiser commercial|all plans percent of total billed charges · outpatientfrom % of charges | $9.2k | $9.2k | — | — | 1–10 | $9.2k – $9.2k |
| 14 | Anthem commercial|exchange case rate · outpatient | $15.6k | $15.6k | — | — | — | $15.6k – $15.6k |
| 15 | Anthem commercial|all other plans case rate · outpatient | $23.6k | $23.6k | — | — | — | $23.6k – $23.6k |
| 16 | Anthem commercial|mcs case rate · outpatient | $29.0k | $29.0k | — | — | — | $29.0k – $29.0k |
Last updated: Feb 28, 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.