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
12004,RT RPR S/N/AX/GEN/TRK7.6-12.5CM
Peru, IN
See all hospitals reporting CPT 12004 →Price type
Dukes Health System LLC’s median price of $181 is 37% below the median hospital's median price ($287), higher than 13% 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: 11 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 | Anthem anthem in hip facility · fee schedule · outpatient | $74 | $74 | $18 | 24% | — | $56 – $92 |
| 2 | Aetna aetna nbd facility · percent of total billed charges · inpatientfrom % of charges | $133 | $133 | $32 | 24% | — | $100 – $165 |
| 3 | Aetna aetna pssd jj facility · percent of total billed charges · inpatientfrom % of charges | $133 | $133 | $32 | 24% | — | $100 – $165 |
| 4 | UnitedHealthcare uhc apa facility · percent of total billed charges · inpatientfrom % of charges | $181 | $181 | $44 | 24% | — | $137 – $225 |
| 5 | Tricare node tricare facility · fee schedule · outpatient | $85 | $245 | $434 | 177% | — | $52 – $1.3k |
| 6 | Anthem node anthem in mcr select facility · fee schedule · outpatient | $90 | $261 | $461 | 177% | — | $55 – $1.4k |
| 7 | Humana node humana mcr adv facility · fee schedule · outpatient | $90 | $261 | $461 | 177% | — | $55 – $1.4k |
| 8 | UnitedHealthcare node uhc mcr adv facility · fee schedule · outpatient | $90 | $261 | $461 | 177% | — | $55 – $1.4k |
| 9 | Anthem node anthem in mcr adv facility · fee schedule · outpatient | $92 | $265 | $469 | 177% | — | $56 – $1.4k |
| 10 | Optum node united optum va ccn facility · per diem · outpatient | $92 | $265 | $469 | 177% | — | $56 – $1.4k |
| 11 | Aetna node aetna mcr adv facility · fee schedule · outpatient | $92 | $266 | $471 | 177% | — | $56 – $1.4k |
| 12 | Devoted node devoted health mcr adv facility · fee schedule · outpatient | $92 | $266 | $471 | 177% | — | $56 – $1.4k |
| 13 | First Health first health facility · percent of total billed charges · inpatientfrom % of charges | $295 | $295 | $72 | 24% | — | $223 – $366 |
| 14 | MultiPlan multiplan complementary facility · percent of total billed charges · inpatientfrom % of charges | $298 | $298 | $73 | 24% | — | $226 – $371 |
| 15 | MultiPlan multiplan primary facility · percent of total billed charges · inpatientfrom % of charges | $298 | $298 | $73 | 24% | — | $226 – $371 |
| 16 | Anthem node anthem essentials marketplace facility · fee schedule · outpatient | $137 | $398 | $703 | 177% | — | $84 – $2.1k |
| 17 | Anthem anthem in work comp facility · other · outpatient | $147 | $424 | $750 | 177% | — | $89 – $2.3k |
| 18 | Aetna aetna nbd facility · percent of total billed charges · outpatientfrom % of charges | $165 | $477 | $844 | 177% | — | $100 – $2.5k |
| 19 | Aetna aetna pssd jj facility · percent of total billed charges · outpatientfrom % of charges | $165 | $477 | $844 | 177% | — | $100 – $2.5k |
| 20 | Cigna cigna all facility · percent of total billed charges · outpatientfrom % of charges | $194 | $562 | $994 | 177% | — | $118 – $3.0k |
| 21 | Aetna aetna all facility · percent of total billed charges · outpatientfrom % of charges | $218 | $631 | $1.1k | 177% | — | $133 – $3.4k |
| 22 | Anthem anthem in marketplace stld facility · fee schedule · outpatient | $698 | $698 | — | — | — | $698 – $698 |
| 23 | Anthem anthem in healthsync facility · fee schedule · outpatient | $715 | $715 | — | — | — | $715 – $715 |
| 24 | Caresource caresource in medicaid facility · other · outpatient | $804 | $804 | — | — | — | $804 – $804 |
| 25 | Anthem anthem in hmo ppo trad facility · fee schedule · outpatient | $872 | $872 | — | — | — | $872 – $872 |
Last updated: Apr 1, 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.