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 Repair Intermediate Wounds Face/Ears/Eyelids/Nose/Lips/Muc Memb 7.6 - 12.5 Cm
Troy, NY
See all hospitals reporting CPT 12054 →Price type
Samaritan Hospital’s median price of $4.7k is 756% above the median hospital's median price ($554), higher than 99% 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: 13 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Anthem empire medicaid facility · fee schedule · outpatient | $231 | $231 | — | — | — | $231 – $231 |
| 2 | Excellus empire medicaid facility · fee schedule · outpatient | $231 | $231 | — | — | — | $231 – $231 |
| 3 | UnitedHealthcare united healthcare medicaid harp chip facility · fee schedule · outpatient | $266 | $266 | — | — | — | $266 – $266 |
| 4 | Anthem empire medicaid essential 1 2 3 4 facility · fee schedule · outpatient | $491 | $491 | — | — | — | $491 – $491 |
| 5 | Excellus empire medicaid essential 1 2 3 4 facility · fee schedule · outpatient | $491 | $491 | — | — | — | $491 – $491 |
| 6 | UnitedHealthcare uhc essential plan medicaid facility · fee schedule · outpatient | $904 | $904 | — | — | — | $904 – $904 |
| 7 | Anthem empire bcbs medicare advantage facility · other · outpatient | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 8 | UnitedHealthcare united healthcare medicare advantage facility · other · outpatient | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 9 | Aetna aetna medicare advantage facility · other · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 10 | WellCare wellcare medicare advantage facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 11 | Excellus blue shield of ne new york medicare adv facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 12 | Highmark blue shield of ne new york medicare adv facility · other · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 13 | Highmark blue shield of ne new york ascend facility · other · outpatient | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 14 | WellCare wellcare ep 1&2 medicaid facility · other · outpatient | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 15 | Blue Cross Blue Shield blue shield of ne new york hmo facility · other · outpatient | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 16 | Carefirst blue shield of ne new york hmo facility · other · outpatient | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 17 | Highmark blue shield of ne new york hmo facility · other · outpatient | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 18 | Wellmark blue shield of ne new york hmo facility · other · outpatient | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 19 | Aetna aetna facility · other · outpatient | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 20 | Medical Mutual aetna facility · other · outpatient | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 21 | Anthem empire bcbs blue access facility · other · outpatient | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 22 | Anthem empire bcbs hmo epo ppo indemnity facility · other · outpatient | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 23 | Blue Cross Blue Shield empire bcbs hmo epo ppo indemnity facility · other · outpatient | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 24 | UnitedHealthcare empire bcbs hmo epo ppo indemnity facility · other · outpatient | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
| 25 | Wellmark empire bcbs hmo epo ppo indemnity facility · other · outpatient | $4.7k | $4.7k | — | — | — | $4.7k – $4.7k |
Last updated: Mar 31, 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.