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 7.6to12.5mlp
Perryville, MO
See all hospitals reporting CPT 12054 →Price type
Mercy Perry’s median price of $696 is 26% above the median hospital's median price ($554), higher than 61% of the 2,222 hospitals reporting CPT 12054. 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 | $172 | $172 | $14 | 8% | — | $158 – $186 |
| 2 | Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $349 | $349 | $28 | 8% | — | $321 – $377 |
| 3 | Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $349 | $349 | $28 | 8% | — | $321 – $377 |
| 4 | Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $349 | $349 | $28 | 8% | — | $321 – $377 |
| 5 | Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $349 | $349 | $28 | 8% | — | $321 – $377 |
| 6 | UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $349 | $349 | $28 | 8% | — | $321 – $377 |
| 7 | WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $349 | $349 | $28 | 8% | — | $321 – $377 |
| 8 | UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $355 | $355 | $29 | 8% | — | $327 – $384 |
| 9 | Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $363 | $363 | $29 | 8% | — | $333 – $392 |
| 10 | Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $363 | $363 | $29 | 8% | — | $333 – $392 |
| 11 | Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $416 | $416 | $34 | 8% | — | $382 – $449 |
| 12 | Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · fee schedule · outpatient | $477 | $477 | — | — | — | $477 – $477 |
| 13 | Medicaid hb pcmh mo medicaid facility · fee schedule · outpatient | $477 | $477 | — | — | — | $477 – $477 |
| 14 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $482 | $482 | $39 | 8% | — | $443 – $520 |
| 15 | UnitedHealthcare hb pcmh uhc managed medicaid facility · fee schedule · outpatient | $525 | $525 | — | — | — | $525 – $525 |
| 16 | Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $543 | $543 | $44 | 8% | — | $500 – $587 |
| 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 | $545 | $545 | $44 | 8% | — | $501 – $589 |
| 18 | UnitedHealthcare hb pcmh uhc core facility · percent of total billed charges · outpatientfrom % of charges | $654 | $654 | $53 | 8% | — | $601 – $706 |
| 19 | Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $711 | $711 | $57 | 8% | — | $653 – $768 |
| 20 | Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges | $711 | $711 | $57 | 8% | — | $653 – $768 |
| 21 | Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $751 | $751 | $61 | 8% | — | $690 – $812 |
| 22 | First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $751 | $751 | $61 | 8% | — | $690 – $812 |
| 23 | Optum hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $757 | $757 | $61 | 8% | — | $696 – $818 |
| 24 | UnitedHealthcare hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $757 | $757 | $61 | 8% | — | $696 – $818 |
| 25 | Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $803 | $803 | $65 | 8% | — | $738 – $867 |
Last updated: Mar 12, 2026
See Intermediate repair of face wound, 7.6-12.5 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.