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
Int Rep F/Een/Lp/Muc 2.6to5.0
Ozark, MO
See all hospitals reporting CPT 12052 →Price type
Mercy Hospital Springfield’s median price of $399 is 21% below the median hospital's median price ($508), higher than 25% of the 2,395 hospitals reporting CPT 12052. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 14 payers, 33 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 | Blue Cross Blue Shield hb sprg medicare facility · fee schedule · outpatient | $161 | $161 | — | — | — | $161 – $161 |
| 2 | Medicaid hb sprg/jopl ark medicaid facility · fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 3 | Medicaid hb sprg/jopl ark medicaid facility · case rate · outpatient | $297 | $297 | — | — | — | $297 – $297 |
| 4 | Blue Cross Blue Shield hb sprg missouri care plan/healthy blue facility · fee schedule · outpatient | $341 | $341 | — | — | — | $341 – $341 |
| 5 | Medicaid hb sprg mo medicaid facility · fee schedule · outpatient | $341 | $341 | — | — | — | $341 – $341 |
| 6 | UnitedHealthcare hb sprg uhc mo medicaid facility · fee schedule · outpatient | $341 | $341 | — | — | 1–10 | $341 – $341 |
| 7 | Blue Cross Blue Shield hb sprg kancare healthy blue medicaid facility · fee schedule · outpatient | $343 | $343 | — | — | — | $343 – $343 |
| 8 | Humana hb sprg humana facility · fee schedule · outpatient | $383 | $383 | — | — | — | $383 – $383 |
| 9 | Aetna hb sprg medicare facility · other · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 10 | Blue Cross Blue Shield hb sprg medicare facility · other · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 11 | Cigna hb sprg medicare facility · other · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 12 | Humana hb sprg humana medicare 100% facility · other · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 13 | Medica hb sprg medicare facility · other · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 14 | Medicare hb sprg medicare facility · other · outpatient | $399 | $399 | — | — | 1–10 | $399 – $399 |
| 15 | Tricare hb sprg tricare facility · other · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 16 | UnitedHealthcare hb sprg medicare facility · other · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 17 | UnitedHealthcare hb sprg uhc mcr 100% facility · other · outpatient | $399 | $399 | — | — | — | $399 – $399 |
| 18 | WellCare hb sprg & lebn wellcare mcr 103% facility · other · outpatient | $412 | $412 | — | — | — | $412 – $412 |
| 19 | Devoted hb sprg devoted health medicare advantage 104% w/seq facility · other · outpatient | $416 | $416 | — | — | — | $416 – $416 |
| 20 | Aetna hb sprg aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $540 | $540 | — | — | — | $540 – $540 |
| 21 | Blue Cross Blue Shield hb sprg anthem pathways exchange facility · percent of total billed charges · outpatientfrom % of charges | $540 | $540 | — | — | — | $540 – $540 |
| 22 | First Health hb sprg aetna first health-network access facility · percent of total billed charges · outpatientfrom % of charges | $605 | $605 | — | — | — | $605 – $605 |
| 23 | Humana hb sprg humana facility · percent of total billed charges · outpatientfrom % of charges | $734 | $734 | — | — | — | $734 – $734 |
| 24 | Cigna hb sprg cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $745 | $745 | — | — | — | $745 – $745 |
| 25 | Blue Cross Blue Shield hb sprg anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $788 | $788 | — | — | — | $788 – $788 |
Last updated: Jun 4, 2026
See Intermediate repair of face and mouth wound, 2.6-5.0 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.