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
HCHG LO FLEXIBLE L1 < L5 PREFAB OTS PR20
River Falls, WI
See all hospitals reporting HCPCS L0625 →Price type
Allina Health Systems’s median price of $93 is 110% above the median hospital's median price ($45), higher than 87% of the 1,249 hospitals reporting HCPCS L0625. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 20 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 | Aetna allina aetna medicare (r) facility · fee schedule · outpatient | $39 | $34 | $10 | 31% | — | $9 – $39 |
| 2 | Medicare medicare (r) facility · fee schedule · outpatient | $41 | $36 | $11 | 31% | — | $9 – $41 |
| 3 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $33 | $36 | $28 | 78% | — | $2 – $82 |
| 4 | Medicaid medicaid ma (r) facility · fee schedule · outpatient | $42 | $36 | $11 | 31% | — | $9 – $42 |
| 5 | Bcbs Mn bc pmap (r) facility · fee schedule · outpatient | $39 | $39 | — | — | — | $39 – $39 |
| 6 | Medica medica pmap (r) facility · percent of total billed charges · outpatientfrom % of charges | $44 | $48 | $37 | 78% | — | $2 – $110 |
| 7 | Blue Cross Blue Shield bc medicare (r) facility · fee schedule · outpatient | $72 | $79 | $62 | 78% | — | $4 – $181 |
| 8 | Medica medica medicare (r) facility · fee schedule · outpatient | $72 | $79 | $62 | 78% | — | $4 – $181 |
| 9 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $73 | $80 | $63 | 78% | — | $4 – $183 |
| 10 | Bcbs Mn bc state health plan (r) facility · fee schedule · outpatient | $96 | $96 | — | — | — | $96 – $96 |
| 11 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $99 | $109 | $85 | 78% | — | $6 – $250 |
| 12 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $100 | $110 | $86 | 78% | — | $6 – $252 |
| 13 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $107 | $118 | $92 | 78% | — | $6 – $270 |
| 14 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $108 | $119 | $93 | 78% | — | $6 – $272 |
| 15 | Bcbs Mn bc premier (r) facility · fee schedule · outpatient | $123 | $123 | — | — | — | $123 – $123 |
| 16 | Blue Cross Blue Shield bc aehp (r) facility · fee schedule · outpatient | $145 | $145 | — | — | — | $145 – $145 |
| 17 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $136 | $150 | $117 | 78% | — | $8 – $342 |
| 18 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $136 | $150 | $117 | 78% | — | $8 – $342 |
| 19 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $137 | $151 | $118 | 78% | — | $8 – $345 |
| 20 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $138 | $152 | $119 | 78% | — | $8 – $348 |
Last updated: Jun 15, 2026
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