Repair of a superficial wound, 7.6 to 12.5 cm at Mercy Perry

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Simp Rep S/Nk/Tr/Ext 7.6to12.5mlp

Perryville, MO

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How this price compares nationally

Mercy Perry’s median price of $357 is 25% above the median hospital's median price ($287), higher than 60% of the 2,435 hospitals reporting CPT 12004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 12004 at Mercy Perry

Negotiated rates from the hospital’s own file: 16 payers, 29 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	Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges	$88	$88	$7	8%	—	$81 – $96
2	Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$179	$179	$15	8%	—	$165 – $194
3	Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$179	$179	$15	8%	—	$165 – $194
4	Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$179	$179	$15	8%	—	$165 – $194
5	Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$179	$179	$15	8%	—	$165 – $194
6	UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$179	$179	$15	8%	—	$165 – $194
7	WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$179	$179	$15	8%	—	$165 – $194
8	UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges	$183	$183	$15	8%	—	$168 – $197
9	Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges	$186	$186	$15	8%	—	$171 – $201
10	Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges	$186	$186	$15	8%	—	$171 – $201
11	Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges	$214	$214	$17	8%	—	$196 – $231
12	Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · fee schedule · outpatient	$237	$237	—	—	—	$237 – $237
13	Medicaid hb pcmh mo medicaid facility · fee schedule · outpatient	$237	$237	—	—	—	$237 – $237
14	Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges	$247	$247	$20	8%	—	$227 – $268
15	UnitedHealthcare hb pcmh uhc managed medicaid facility · fee schedule · outpatient	$261	$261	—	—	—	$261 – $261
16	Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges	$279	$279	$23	8%	—	$256 – $302
17	Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges	$280	$280	$23	8%	—	$257 – $303
18	UnitedHealthcare hb pcmh uhc core facility · percent of total billed charges · outpatientfrom % of charges	$336	$336	$27	8%	—	$308 – $363
19	Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges	$365	$365	$30	8%	—	$335 – $395
20	Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges	$365	$365	$30	8%	—	$335 – $395
21	Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges	$386	$386	$31	8%	—	$354 – $417
22	First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges	$386	$386	$31	8%	—	$354 – $417
23	Optum hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges	$389	$389	$32	8%	—	$357 – $420
24	UnitedHealthcare hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges	$389	$389	$32	8%	—	$357 – $420
25	Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges	$412	$412	$34	8%	—	$379 – $446

Page 1 of 2 · 29 rates

Last updated: Mar 12, 2026

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