Code: 12004

Description:
HC SMPL RPR SUPFC S/N/AX/G/T 7.6CM-12.5CM
Other Descriptions:
SIM LAC SCLP-BDY 7.6-12.5CM
RSW SIMP H/N/T/E 7.6-12.5CM
PC WOUND GEN 7.6 - 12.5CM
ER REPA-SUTUR 2IN TO 3IN
REPAIR SW SCALP/NECK 7.6-
SIMP.LAC.RPR 7.6-12.5CM
SIMP RPR SCP AX GN TNK EXT PHY
REPAIR SIM A 7.6+AC0-12.5CM PF
Rpr s/n/ax/gen/trk7.6+AC0-12.5cm
Related codes:
Code: 12001
PRO-SIMPLE REPAIR SCALP
Code: 12002
HC SMPL RPR SUPFC S/N/AX/G/T 2.6CM-7.5CM
Code: 12005
HC SMPL RPR SUPFC S/N/AX/G/T 12.6CM-20.0CM
Code: 12006
HC SMPL RPR SUPFC S/N/AX/G/T 20.1CM-30.0CM
Code: 12007
HC SMPL RPR SUPFC S/N/AX/G/T > 30.0CM
Idaho
Hospital Address Code Price Last Updated
Boundary Community Hospital 6640 Kaniksu St, Bonners Ferry 12004 $106 [source] 3 years ago
Shoshone Medical Center 25 Jacobs Gulch Rd, Kellogg 12004 $141 [source] 3 years ago
Bonner General Hospital 520 N 3Rd Ave, Sandpoint 12004 $190 [source] 3 years ago
Lost Rivers Medical Center 551 Highland Dr, Arco 12004 $198 [source] 3 years ago
North Canyon Medical Center 267 North Canyon Drive, Gooding 12004 $243 [source] 3 years ago
Caribou Memorial Hospital 300 S 3Rd W, Soda Springs 12004 $264 [source] 3 years ago
Power County Hospital 510 Roosevelt St, American Falls 12004 $297 [source] 3 years ago
West Valley Medical Center 3720 S Indiana Ave, Caldwell 12004 $409 [source] 3 years ago
Steele Memorial Medical Center 203 S Daisy St, Salmon 12004 $422 [source] 3 years ago
Bear Lake Memorial Hospital 164 S 5Th St, Montpelier 12004 $480 [source] 3 years ago
Minidoka Medical Center 1308 8Th St, Suite 1, Rupert 12004 $481 [source] 3 years ago
Kootenai Health 2003 Kootenai Health Way, Coeur D Alene 12004 $575 [source] 3 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.