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Washington rates for HCPCS 12004

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

Facilitymedian $257 · 10th–90th $105$6,4570%10%20%10th90th$257Professionalmedian $148 · 10th–90th $72$3630%10%10th90th$148$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $309.03 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $128.82 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $537.03 / $1,096.48
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $169.82 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $177.83 / $371.54
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $181.97 / $354.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $181.97 / $331.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $245.47 / $269.15
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $181.97
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $181.97 / $331.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $549.54 / $1,096.48
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $169.82 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $707.95 / $1,584.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $169.82 / $295.12
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $144.54 / $234.42