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 Nk/Hds/Ft/Eg 2.6 to 7.5cm
Perryville, MO
See all hospitals reporting CPT 12042 →Price type
Mercy Perry’s median price of $461 is 9% below the median hospital's median price ($507), higher than 42% of the 2,461 hospitals reporting CPT 12042. 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, 34 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 | $110 | $106 | $8 | 7% | — | $95 – $112 |
| 2 | Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $223 | $214 | $15 | 7% | — | $192 – $226 |
| 3 | Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $223 | $214 | $15 | 7% | — | $192 – $226 |
| 4 | Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $223 | $214 | $15 | 7% | — | $192 – $226 |
| 5 | Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $223 | $214 | $15 | 7% | — | $192 – $226 |
| 6 | UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $223 | $214 | $15 | 7% | — | $192 – $226 |
| 7 | WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $223 | $214 | $15 | 7% | — | $192 – $226 |
| 8 | UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $228 | $218 | $16 | 7% | — | $196 – $231 |
| 9 | Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $232 | $222 | $16 | 7% | — | $200 – $235 |
| 10 | Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $232 | $222 | $16 | 7% | — | $200 – $235 |
| 11 | Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $266 | $255 | $18 | 7% | — | $229 – $270 |
| 12 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $308 | $295 | $21 | 7% | — | $265 – $312 |
| 13 | Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $348 | $333 | $24 | 7% | — | $300 – $353 |
| 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 | $349 | $334 | $24 | 7% | — | $300 – $353 |
| 15 | Medicaid hb pcmh mo medicaid facility · fee schedule · outpatient | $341 | $341 | — | — | — | $341 – $341 |
| 16 | UnitedHealthcare hb pcmh uhc managed medicaid facility · fee schedule · outpatient | $341 | $341 | — | — | — | $341 – $341 |
| 17 | UnitedHealthcare hb pcmh uhc core facility · percent of total billed charges · outpatientfrom % of charges | $418 | $401 | $29 | 7% | — | $360 – $424 |
| 18 | Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $455 | $436 | $31 | 7% | — | $392 – $461 |
| 19 | Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges | $455 | $436 | $31 | 7% | — | $392 – $461 |
| 20 | Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · fee schedule · outpatient | $477 | $443 | $59 | 13% | — | $341 – $477 |
| 21 | Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $481 | $461 | $33 | 7% | — | $414 – $487 |
| 22 | First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $481 | $461 | $33 | 7% | — | $414 – $487 |
| 23 | Optum hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $484 | $464 | $33 | 7% | — | $417 – $491 |
| 24 | UnitedHealthcare hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $484 | $464 | $33 | 7% | — | $417 – $491 |
| 25 | Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $514 | $492 | $35 | 7% | — | $442 – $521 |
Last updated: Mar 12, 2026
See Intermediate wound repair of neck, hands, feet or genitals, 2.6-7.5 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.