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
LSO FLEX NO RI STAYS PRE OTS
Low
$1
Average
$201
Median
$86
High
$2.6k
Filter by billing methodology
Prices here combine facility and professional fees. See them separately →Experimental
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 42 hospitals; the 90th percentile is 7.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | OU Health - University of Oklahoma Medical Center Oklahoma City, OK | $63 | $70 | $21 | 30% | — | $61 – $128 |
| 2 | Northside Hospital, Inc. Lawrenceville, GA | $566 | $457 | $210 | 46% | — | $49 – $1.1k |
| 3 | Metro Knoxville HMA LLC Powell, TN | $70 | $74 | $12 | 17% | — | $63 – $94 |
| 4 | Northside Hospital, Inc. Atlanta, GA | $566 | $466 | $206 | 44% | — | $49 – $1.1k |
| 5 | United Hospital Center Bridgeport, WV | $69 | $80 | $17 | 21% | — | $65 – $114 |
| 6 | Allina Health Systems Shakopee, MN | $134 | $133 | $38 | 28% | — | $58 – $178 |
| 7 | Nationwide Children's Hospital Columbus, OH | $49 | $49 | — | — | — | $49 – $49 |
| 8 | Triad of Alabama LLC Dothan, AL | $334 | $525 | $550 | 105% | — | $65 – $1.4k |
| 9 | Inova Alexandria Hospital Alexandria, VA | $77 | $81 | $27 | 33% | — | $51 – $121 |
| 10 | Wetzel County Hospital, Inc. New Martinsville, WV | $68 | $74 | $13 | 18% | — | $65 – $114 |
Ask Claude or any MCP client for HCPCS L0628 pricing at a specific hospital — see how to connect.