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/<
Lebanon, NH
See all hospitals reporting CPT 12011 →Price type
Mary Hitchcock Memorial Hospital’s median price of $343 is 26% above the median hospital's median price ($272), higher than 62% 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: 10 payers, 103 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 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · fee schedule · outpatient | $32.36 | $32.36 | $32.36 – $32.36 |
| 2 | Amerihealth Caritas amerihealth caritas - nh managed medicaid - dhp professional · fee schedule · outpatient | $34.33 | $34.33 | $34.33 – $34.33 |
| 3 | Anthem anthem - medicare advantage - dhp professional · fee schedule · outpatient | $82.18 | $82.18 | $53.75 – $110.61 |
| 4 | Bcbs Vt bcbs of vermont - medicare advantage - dhp professional · fee schedule · outpatient | $82.18 | $82.18 | $53.75 – $110.61 |
| 5 | UnitedHealthcare uhc - medicare advantage - dhp professional · fee schedule · outpatient | $82.18 | $82.18 | $53.75 – $110.61 |
| 6 | UnitedHealthcare uhc - va community care network - dhpn professional · fee schedule · outpatient | $82.18 | $82.18 | $53.75 – $110.61 |
| 7 | UnitedHealthcare uhc - va community care network - dhps professional · fee schedule · outpatient | $82.18 | $82.18 | $53.75 – $110.61 |
| 8 | Amerihealth Caritas amerihealth caritas - nh managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $82.48 | $82.48 | $82.48 – $82.48 |
| 9 | Aetna aetna medicare advantage - dhp professional · fee schedule · outpatient | $84.64 | $84.64 | $55.36 – $113.92 |
| 10 | Cigna cigna medicare advantage - dhp professional · fee schedule · outpatient | $84.64 | $84.64 | $55.36 – $113.92 |
| 11 | WellCare wellcare - medicare advantage - dhp professional · fee schedule · outpatient | $85.47 | $85.47 | $55.90 – $115.03 |
| 12 | Ambetter ambetter commercial - exchange behavioral health - dhp professional · fee schedule · outpatient | $86.29 | $86.29 | $56.43 – $116.14 |
| 13 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · percent of total billed charges · outpatientfrom % of charges | $129.96 | $129.96 | $129.96 – $129.96 |
| 14 | Anthem anthem shop - exchange - dhp professional · fee schedule · outpatient | $192.69 | $192.69 | $126.93 – $258.45 |
| 15 | Ambetter ambetter commercial - exchange - dhps professional · fee schedule · outpatient | $194.93 | $194.93 | $127.49 – $262.36 |
| 16 | Anthem anthem indiv qhp - exchange - dhp professional · fee schedule · outpatient | $199.17 | $199.17 | $131.20 – $267.13 |
| 17 | Anthem anthem shop - exchange professional · fee schedule · outpatient | $202.86 | $202.86 | $136.70 – $269.02 |
| 18 | Cigna cigna hmo-pos professional · fee schedule · outpatient | $209.27 | $209.27 | $141.16 – $277.37 |
| 19 | Anthem anthem indiv qhp - exchange professional · fee schedule · outpatient | $210.02 | $210.02 | $141.52 – $278.52 |
| 20 | Anthem anthem ppo - dhp professional · fee schedule · outpatient | $220.58 | $220.58 | $145.30 – $295.85 |
| 21 | Anthem anthem - medicare advantage facility · case rate · outpatient | $222.36 | $222.36 | $222.36 – $222.36 |
| 22 | Bcbs Vt bcbs of vermont - medicare advantage facility · case rate · outpatient | $222.36 | $222.36 | $222.36 – $222.36 |
| 23 | UnitedHealthcare uhc - medicare advantage facility · case rate · outpatient | $222.36 | $222.36 | $222.36 – $222.36 |
| 24 | UnitedHealthcare uhc - va community care network facility · case rate · outpatient | $222.36 | $222.36 | $222.36 – $222.36 |
| 25 | Anthem anthem hmo/pos; individual non qhp on or off exch; shop off exch professional · fee schedule · outpatient | $225.41 | $225.41 | $151.89 – $298.92 |
Last updated: Jan 1, 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.