Code: 12054

Description:
HC LYR CLSR F/E/E/N/L/M&/MUC 7.6 CM-12.5 CM
Other Descriptions:
LCW INTER FACE 7.6CM-12.5CM
INT REP 7.6-12.5
HC LCW INTER FACE 7.6CM-12.5CM
INTERM.RPR FACE 7.6-12.5C
LAYER CLOSURE FACIAL 7.6-12.5CM PHY
REPAIR INT C 7.6+AC0-12.5CM PF
Intmd rpr face/mm 7.6+AC0-12.5cm
Repair Fac/ear 7.6-12.5cm
Repair Lay Fac/ear 7.6-12.5cm
Related codes:
Code: 12051
PRO-LYR INTER FACE<2.5
Code: 12052
HC LYR CLSR F/E/E/N/L/M&/MUC 2.6 CM-5.0 CM
Code: 12053
HC LYR CLSR F/E/E/N/L/M&/MUC 5.1 CM-7.5 CM
Code: 12055
HC LYR CLSR F/E/E/N/L/M&/MUC 12.6 CM-20.0 CM
Code: 12056
HC LYR CLSR F/E/E/N/L/M&/MUC 20.1 CM-30.0 CM
Code: 12057
HC LYR CLSR F/E/E/N/L/M&/MUC > 30.0 CM
Idaho
Hospital Address Code Price Last Updated
Boundary Community Hospital 6640 Kaniksu St, Bonners Ferry 12054 $342 [source] 3 years ago
West Valley Medical Center 3720 S Indiana Ave, Caldwell 12054 $349 [source] 3 years ago
Shoshone Medical Center 25 Jacobs Gulch Rd, Kellogg 12054 $424 [source] 3 years ago
Power County Hospital 510 Roosevelt St, American Falls 12054 $457 [source] 3 years ago
Bonner General Hospital 520 N 3Rd Ave, Sandpoint 12054 $574 [source] 3 years ago
Bear Lake Memorial Hospital 164 S 5Th St, Montpelier 12054 $609 [source] 3 years ago
Steele Memorial Medical Center 203 S Daisy St, Salmon 12054 $653 [source] 3 years ago
Caribou Memorial Hospital 300 S 3Rd W, Soda Springs 12054 $685 [source] 3 years ago
North Canyon Medical Center 267 North Canyon Drive, Gooding 12054 $694 [source] 3 years ago
Lost Rivers Medical Center 551 Highland Dr, Arco 12054 $867 [source] 3 years ago
Kootenai Health 2003 Kootenai Health Way, Coeur D Alene 12054 $936 [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.