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
HC SIM REP S/N/A/G/T/E 7.6-12.5C
Quitman, MS
See all hospitals reporting CPT 12004 →Price type
Rush Medical Foundation’s median price of $217 is 24% below the median hospital's median price ($287), higher than 30% of the 2,435 hospitals reporting CPT 12004. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 24 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 all payor fee schedule · outpatient | $61 | $61 | $6 | 10% | — | $55 – $66 |
| 2 | Cigna Healthspring all payor fee schedule · outpatient | $66 | $66 | — | — | — | $66 – $66 |
| 3 | Optum all payor fee schedule · outpatient | $66 | $66 | — | — | — | $66 – $66 |
| 4 | WellCare all payor fee schedule · outpatient | $66 | $66 | — | — | — | $66 – $66 |
| 5 | Molina all payor fee schedule · outpatient | $67 | $92 | $40 | 44% | — | $60 – $148 |
| 6 | Ambetter all payor fee schedule · outpatient | $93 | $93 | — | — | — | $93 – $93 |
| 7 | Aetna all payor fee schedule · outpatient | $139 | $139 | — | — | — | $139 – $139 |
| 8 | UnitedHealthcare all payor fee schedule · outpatient | $189 | $148 | $58 | 39% | — | $66 – $189 |
| 9 | Humana all payor percent of total billed charges · outpatientfrom % of charges | $176 | $176 | — | — | — | $176 – $176 |
| 10 | Cigna all payor fee schedule · outpatient | $209 | $209 | — | — | — | $209 – $209 |
| 11 | Cigna all payor percent of total billed charges · outpatientfrom % of charges | $209 | $209 | — | — | — | $209 – $209 |
| 12 | UnitedHealthcare all payor case rate · outpatient | $217 | $217 | — | — | — | $217 – $217 |
| 13 | Cigna Healthspring all payor other · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 14 | Humana all payor other · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 15 | Optum all payor other · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 16 | UnitedHealthcare all payor other · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 17 | Ambetter all payor other · outpatient | $220 | $220 | — | — | — | $220 – $220 |
| 18 | Molina all payor other · outpatient | $220 | $220 | — | — | — | $220 – $220 |
| 19 | WellCare all payor other · outpatient | $220 | $220 | — | — | — | $220 – $220 |
| 20 | Aetna all payor percent of total billed charges · outpatientfrom % of charges | $244 | $244 | — | — | — | $244 – $244 |
| 21 | Bcbs Ms all payor fee schedule · outpatient | $241 | $245 | $106 | 43% | — | $117 – $377 |
| 22 | MultiPlan all payor percent of total billed charges · outpatientfrom % of charges | $282 | $282 | — | — | — | $282 – $282 |
| 23 | Bcbs Ms all payor other · outpatient | $301 | $301 | — | — | — | $301 – $301 |
| 24 | MultiPlan all payor fee schedule · outpatient | $329 | $329 | — | — | — | $329 – $329 |
Last updated: Apr 1, 2026
See Repair of a superficial wound, 7.6 to 12.5 cm pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.