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 F/E/E/N/L/M 2.5 CM/<
Puyallup, WA
See all hospitals reporting CPT 12011 →Price type
Good Samaritan Hospital’s median price of $295 is 9% above the median hospital's median price ($272), higher than 54% of the 2,366 hospitals reporting CPT 12011. 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, 15 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 | Molina apple health fee schedule · outpatient | $132.69 | $132.69 | $132.69 – $132.69 |
| 2 | UnitedHealthcare apple health fee schedule · outpatient | $143.31 | $143.31 | $143.31 – $143.31 |
| 3 | Aetna medadvantage fee schedule · outpatient | $236.35 | $236.35 | $236.35 – $236.35 |
| 4 | Regence medadvantage fee schedule · outpatient | $236.35 | $236.35 | $236.35 – $236.35 |
| 5 | UnitedHealthcare medadvantage fee schedule · outpatient | $238.65 | $238.65 | $238.65 – $238.65 |
| 6 | Molina medadvantage fee schedule · outpatient | $240.94 | $240.94 | $240.94 – $240.94 |
| 7 | WellCare medadvantage fee schedule · outpatient | $240.94 | $240.94 | $240.94 – $240.94 |
| 8 | Premera hmo fee schedule · outpatient | $338.30 | $338.30 | $338.30 – $338.30 |
| 9 | Ambetter coordinated care exchange fee schedule · outpatient | $458.94 | $458.94 | $458.94 – $458.94 |
| 10 | Premera signature fee schedule · outpatient | $731.47 | $731.47 | $731.47 – $731.47 |
| 11 | Premera prime fee schedule · outpatient | $747.93 | $747.93 | $747.93 – $747.93 |
| 12 | Kaiser ppo fee schedule · outpatient | $836.09 | $836.09 | $836.09 – $836.09 |
| 13 | Premera other commercial plans fee schedule · outpatient | $919.22 | $919.22 | $919.22 – $919.22 |
| 14 | Aetna all commercial plans fee schedule · outpatient | $927.01 | $927.01 | $927.01 – $927.01 |
| 15 | Cigna all commercial plans fee schedule · outpatient | $963.09 | $963.09 | $963.09 – $963.09 |
Last updated: Aug 27, 2026
See Simple repair of facial wound up to 2.5 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.