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
LR CPLX SC/ARM/LG 2.6-7.5
Los Angeles, CA
See all hospitals reporting CPT 13121 →Price type
Dignity Community Care’s median price of $778 is 8% above the median hospital's median price ($720), higher than 56% of the 2,416 hospitals reporting CPT 13121. 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, 22 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 | Kaiser medicaid|< 21 fee schedule · outpatient | $290 | $290 | — | — | — | $290 – $290 |
| 2 | Kaiser medicaid|> 21 fee schedule · outpatient | $290 | $290 | — | — | — | $290 – $290 |
| 3 | Anthem medicaid|all plans fee schedule · outpatient | $302 | $302 | — | — | — | $302 – $302 |
| 4 | Molina medicaid|< 21 fee schedule · outpatient | $427 | $427 | — | — | — | $427 – $427 |
| 5 | Molina medicaid|> 21 fee schedule · outpatient | $427 | $427 | — | — | — | $427 – $427 |
| 6 | Aetna medicare|all plans fee schedule · outpatient | $778 | $778 | — | — | — | $778 – $778 |
| 7 | Anthem medicare|all plans fee schedule · outpatient | $778 | $778 | — | — | — | $778 – $778 |
| 8 | Blue Cross Blue Shield medicare|all other plans case rate · outpatient | $778 | $778 | — | — | — | $778 – $778 |
| 9 | Molina medicare|all plans fee schedule · outpatient | $778 | $778 | — | — | — | $778 – $778 |
| 10 | UnitedHealthcare medicare|all plans case rate · outpatient | $778 | $778 | — | — | — | $778 – $778 |
| 11 | Blue Cross Blue Shield medicaid|all plans fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 12 | First Health commercial|all plans fee schedule · inpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 13 | First Health commercial|all plans fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 14 | Kaiser commercial|all plans fee schedule · inpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 15 | Kaiser commercial|all plans fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 16 | Blue Cross Blue Shield medicare|promise fee schedule · outpatient | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 17 | MultiPlan commercial|all plans fee schedule · inpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 18 | MultiPlan commercial|all plans fee schedule · outpatient | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 19 | Blue Cross Blue Shield commercial|exchange case rate · outpatient | $4.2k | $4.2k | — | — | — | $4.2k – $4.2k |
| 20 | Anthem commercial|exchange case rate · outpatient | $15.6k | $15.6k | — | — | — | $15.6k – $15.6k |
| 21 | Anthem commercial|all other plans case rate · outpatient | $23.6k | $23.6k | — | — | — | $23.6k – $23.6k |
| 22 | Anthem commercial|mcs case rate · outpatient | $29.0k | $29.0k | — | — | — | $29.0k – $29.0k |
Last updated: Feb 28, 2026
See Complex wound repair, 2.6 to 7.5 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.