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
HC REPAIR SMPL F/E/E/N/L/M 2.5 CM/<
Leesburg, VA
See all hospitals reporting CPT 12011 →Price type
Inova Loudoun Hospital’s median price of $457 is 68% above the median hospital's median price ($272), higher than 76% 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: 7 payers, 27 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 medicare advantage fee schedule · both | $198.70 | $198.70 | $198.70 – $198.70 |
| 2 | Anthem medicare advantage fee schedule · both | $198.70 | $198.70 | $198.70 – $198.70 |
| 3 | UnitedHealthcare medicare advantage fee schedule · both | $198.70 | $198.70 | $198.70 – $198.70 |
| 4 | Cigna medicare advantage fee schedule · both | $206.65 | $206.65 | $206.65 – $206.65 |
| 5 | Kaiser medicare advantage fee schedule · both | $206.65 | $206.65 | $206.65 – $206.65 |
| 6 | Humana medicare advantage fee schedule · both | $218.57 | $218.57 | $218.57 – $218.57 |
| 7 | Anthem medicaid advantage fee schedule · both | $273.52 | $273.52 | $273.52 – $273.52 |
| 8 | UnitedHealthcare medicaid advantage fee schedule · both | $278.99 | $278.99 | $278.99 – $278.99 |
| 9 | Humana medicaid advantage fee schedule · both | $284.46 | $284.46 | $284.46 – $284.46 |
| 10 | Aetna medicaid advantage fee schedule · both | $287.20 | $287.20 | $287.20 – $287.20 |
| 11 | Kaiser medicaid advantage fee schedule · both | $300.87 | $300.87 | $300.87 – $300.87 |
| 12 | Cigna exchange percent of total billed charges · bothfrom % of charges | $344.58 | $344.58 | $344.58 – $344.58 |
| 13 | Aetna hmo percent of total billed charges · bothfrom % of charges | $428.20 | $428.20 | $428.20 – $428.20 |
| 14 | Aetna ppo percent of total billed charges · bothfrom % of charges | $428.20 | $428.20 | $428.20 – $428.20 |
| 15 | Aetna fannie-mae other · both | $449.38 | $449.38 | $449.38 – $449.38 |
| 16 | Anthem exchange hmo fee schedule · both | $464.15 | $464.15 | $464.15 – $464.15 |
| 17 | Cigna hmo percent of total billed charges · bothfrom % of charges | $486.93 | $486.93 | $486.93 – $486.93 |
| 18 | Cigna ppo percent of total billed charges · bothfrom % of charges | $486.93 | $486.93 | $486.93 – $486.93 |
| 19 | Anthem hmo fee schedule · both | $535.04 | $535.04 | $535.04 – $535.04 |
| 20 | Anthem ppo fee schedule · both | $535.04 | $535.04 | $535.04 – $535.04 |
| 21 | Kaiser hmo percent of total billed charges · bothfrom % of charges | $588.12 | $588.12 | $588.12 – $588.12 |
| 22 | Kaiser ppo other · both | $588.12 | $588.12 | $588.12 – $588.12 |
| 23 | Carefirst hmo fee schedule · both | $1,043 | $1,043 | $1,043 – $1,043 |
| 24 | Carefirst ppo fee schedule · both | $1,054 | $1,054 | $1,054 – $1,054 |
| 25 | UnitedHealthcare exchange fee schedule · both | $1,127 | $1,127 | $1,127 – $1,127 |
Last updated: Apr 1, 2026
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