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 12011 SMPL REP F/E/E/N/L/MM; <=2.5CM
San Antonio, TX
See all hospitals reporting CPT 12011 →Price type
Santa Rosa Hospital - Westover Hills’s median price of $194 is 29% below the median hospital's median price ($272), higher than 21% of the 2,366 hospitals reporting CPT 12011. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 12 payers, 35 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 | Cigna new business case rate · outpatient | $129.00 | $129.00 | $129.00 – $129.00 |
| 2 | Bcbs Tx blue advantangehmo fee schedule · outpatient | $159.00 | $159.00 | $159.00 – $159.00 |
| 3 | Aetna chip km percent of total billed charges · outpatientfrom % of charges | $161.32 | $161.32 | $160.82 – $161.81 |
| 4 | Aetna star km percent of total billed charges · outpatientfrom % of charges | $161.32 | $161.32 | $160.82 – $161.81 |
| 5 | Bcbs Tx star chip km percent of total billed charges · outpatientfrom % of charges | $161.32 | $161.32 | $160.82 – $161.81 |
| 6 | Cigna ppo case rate · outpatient | $164.00 | $164.00 | $164.00 – $164.00 |
| 7 | Aetna mm fee schedule · outpatient | $186.58 | $186.58 | $186.58 – $186.58 |
| 8 | Bcbs Tx mm fee schedule · outpatient | $186.58 | $186.58 | $186.58 – $186.58 |
| 9 | Humana gold choice mm fee schedule · outpatient | $186.58 | $186.58 | $186.58 – $186.58 |
| 10 | Humana gold plus mm fee schedule · outpatient | $186.58 | $186.58 | $186.58 – $186.58 |
| 11 | Molina medicare adv mm fee schedule · outpatient | $186.58 | $186.58 | $186.58 – $186.58 |
| 12 | UnitedHealthcare mm fee schedule · outpatient | $186.58 | $186.58 | $186.58 – $186.58 |
| 13 | WellCare mm fee schedule · outpatient | $186.58 | $186.58 | $186.58 – $186.58 |
| 14 | Humana choicecare other · outpatient | $199.00 | $199.00 | $199.00 – $199.00 |
| 15 | Devoted mm fee schedule · outpatient | $201.51 | $201.51 | $201.51 – $201.51 |
| 16 | Bcbs Tx hmo fee schedule · outpatient | $204.43 | $204.43 | $204.43 – $204.43 |
| 17 | Bcbs Tx heb fee schedule · outpatient | $209.68 | $209.68 | $209.68 – $209.68 |
| 18 | Bcbs Tx ppo fee schedule · outpatient | $232.39 | $232.39 | $232.39 – $232.39 |
| 19 | Bcbs Tx traditional fee schedule · outpatient | $239.38 | $239.38 | $239.38 – $239.38 |
| 20 | UnitedHealthcare chip km percent of total billed charges · outpatientfrom % of charges | $263.97 | $263.97 | $263.16 – $264.78 |
| 21 | UnitedHealthcare star km percent of total billed charges · outpatientfrom % of charges | $263.97 | $263.97 | $263.16 – $264.78 |
| 22 | UnitedHealthcare star plus km percent of total billed charges · outpatientfrom % of charges | $263.97 | $263.97 | $263.16 – $264.78 |
| 23 | Molina chip km percent of total billed charges · outpatientfrom % of charges | $439.95 | $439.95 | $438.60 – $441.30 |
| 24 | Molina star plus km percent of total billed charges · outpatientfrom % of charges | $439.95 | $439.95 | $438.60 – $441.30 |
| 25 | First Health hmo percent of total billed charges · outpatientfrom % of charges | $703.92 | $703.92 | $701.76 – $706.08 |
Last updated: Jan 13, 2026
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