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
PF RPR CMPLX S/A&/L ADD 5.0CM
Page, AZ
See all hospitals reporting CPT 13122 →Price type
Page Hospital’s median price of $128 is 74% below the median hospital's median price ($500), higher than 15% of the 2,080 hospitals reporting CPT 13122. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 22 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 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $74 | $74 | — | — | — | $74 – $74 |
| 2 | Humana medicare advantage facility · fee schedule · outpatient | $80 | $80 | — | — | — | $80 – $80 |
| 3 | Aetna banner employee plans facility · percent of total billed charges · outpatientfrom % of charges | $109 | $109 | — | — | — | $109 – $109 |
| 4 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $116 | $116 | — | — | — | $116 – $116 |
| 5 | Bcbs Az medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $116 | $116 | — | — | — | $116 – $116 |
| 6 | Cigna hmo medicare advantage plan/ppo medicare advantage plan facility · percent of total billed charges · outpatientfrom % of charges | $116 | $116 | — | — | — | $116 – $116 |
| 7 | Kaiser medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $116 | $116 | — | — | — | $116 – $116 |
| 8 | Devoted medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $128 | $128 | — | — | — | $128 – $128 |
| 9 | Bcbs Az bxbsaz neighborhood facility · percent of total billed charges · outpatientfrom % of charges | $130 | $130 | — | — | — | $130 – $130 |
| 10 | Bcbs Az bxbsaz alliance/bxbsaz blue hpn facility · percent of total billed charges · outpatientfrom % of charges | $138 | $138 | — | — | — | $138 – $138 |
| 11 | Bcbs Az bxbsaz alliance chs facility · percent of total billed charges · outpatientfrom % of charges | $145 | $145 | — | — | — | $145 – $145 |
| 12 | Aetna aetna qualified health plan facility · percent of total billed charges · outpatientfrom % of charges | $158 | $158 | — | — | — | $158 – $158 |
| 13 | Aetna joint venture facility · percent of total billed charges · outpatientfrom % of charges | $159 | $159 | — | — | — | $159 – $159 |
| 14 | Bcbs Az bcbsaz medicare facility · percent of total billed charges · outpatientfrom % of charges | $173 | $173 | — | — | — | $173 – $173 |
| 15 | Bcbs Az bcbsaz workers comp facility · percent of total billed charges · outpatientfrom % of charges | $173 | $173 | — | — | — | $173 – $173 |
| 16 | Bcbs Az commercial facility · percent of total billed charges · outpatientfrom % of charges | $173 | $173 | — | — | — | $173 – $173 |
| 17 | Oscar commercial facility · percent of total billed charges · outpatientfrom % of charges | $192 | $192 | — | — | — | $192 – $192 |
| 18 | Aetna medical rental facility · percent of total billed charges · inpatientfrom % of charges | $195 | $195 | — | — | — | $195 – $195 |
| 19 | Aetna medical rental facility · percent of total billed charges · outpatientfrom % of charges | $195 | $195 | — | — | — | $195 – $195 |
| 20 | Aetna broad network facility · percent of total billed charges · outpatientfrom % of charges | $199 | $199 | — | — | — | $199 – $199 |
| 21 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · percent of total billed charges · inpatientfrom % of charges | $202 | $202 | — | — | — | $202 – $202 |
| 22 | Cigna commerical/hmo benefit plan/local flex plan/network benefit plan/open access plan facility · percent of total billed charges · outpatientfrom % of charges | $202 | $202 | — | — | — | $202 – $202 |
Last updated: Mar 2, 2026
See Complex repair of scalp, arm or leg wound, 5 cm or less extra pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.