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
Simp Rep S/Nk/Tr/Ext 12.6to20 Mlp
Perryville, MO
See all hospitals reporting CPT 12005 →Price type
Mercy Perry’s median price of $477 is 4% below the median hospital's median price ($495), higher than 48% of the 2,361 hospitals reporting CPT 12005. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
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 | $107 | $107 | $9 | 8% | — | $98 – $116 |
| 2 | Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $217 | $217 | $17 | 8% | — | $199 – $234 |
| 3 | Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $217 | $217 | $17 | 8% | — | $199 – $234 |
| 4 | Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $217 | $217 | $17 | 8% | — | $199 – $234 |
| 5 | Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $217 | $217 | $17 | 8% | — | $199 – $234 |
| 6 | UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $217 | $217 | $17 | 8% | — | $199 – $234 |
| 7 | WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $217 | $217 | $17 | 8% | — | $199 – $234 |
| 8 | UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $221 | $221 | $18 | 8% | — | $203 – $239 |
| 9 | Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $225 | $225 | $18 | 8% | — | $207 – $243 |
| 10 | Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $225 | $225 | $18 | 8% | — | $207 – $244 |
| 11 | Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $258 | $258 | $21 | 8% | — | $237 – $279 |
| 12 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $299 | $299 | $24 | 8% | — | $275 – $323 |
| 13 | Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $338 | $338 | $27 | 8% | — | $310 – $365 |
| 14 | Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges | $338 | $338 | $27 | 8% | — | $311 – $366 |
| 15 | UnitedHealthcare hb pcmh uhc core facility · percent of total billed charges · outpatientfrom % of charges | $406 | $406 | $33 | 8% | — | $373 – $439 |
| 16 | Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $442 | $442 | $36 | 8% | — | $406 – $477 |
| 17 | Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges | $442 | $442 | $36 | 8% | — | $406 – $477 |
| 18 | Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $467 | $467 | $38 | 8% | — | $429 – $504 |
| 19 | First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $467 | $467 | $38 | 8% | — | $429 – $504 |
| 20 | Optum hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $470 | $470 | $38 | 8% | — | $432 – $508 |
| 21 | UnitedHealthcare hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $470 | $470 | $38 | 8% | — | $432 – $508 |
| 22 | Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · fee schedule · outpatient | $477 | $477 | — | — | — | $477 – $477 |
| 23 | Medicaid hb pcmh mo medicaid facility · fee schedule · outpatient | $477 | $477 | — | — | — | $477 – $477 |
| 24 | Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $499 | $499 | $40 | 8% | — | $459 – $539 |
| 25 | Blue Cross Blue Shield hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $499 | $499 | $40 | 8% | — | $459 – $539 |
Last updated: Mar 12, 2026
See Simple wound repair on trunk or genitals, 12.6-20 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.