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 CSTM L0625 LO FLEX L1-BELOW L5 PRE OTS
Ulm, MN
See all hospitals reporting HCPCS L0625 →Price type
Allina Health Systems’s median price of $97 is 117% 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: 9 payers, 24 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 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $31 | $32 | $25 | 78% | — | $2 – $74 |
| 2 | Aetna allina aetna medicare (n) facility · fee schedule · outpatient | $39 | $33 | $11 | 33% | — | $8 – $39 |
| 3 | Medicare medicare (n) facility · fee schedule · outpatient | $41 | $35 | $12 | 33% | — | $8 – $41 |
| 4 | Bcbs Mn bc pmap (n) facility · other · outpatient | $39 | $39 | — | — | — | $39 – $39 |
| 5 | Medica medica pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $49 | $51 | $40 | 78% | — | $3 – $117 |
| 6 | Medicaid medicaid ma (n) facility · other · outpatient | $68 | $71 | $55 | 78% | — | $4 – $161 |
| 7 | Medica medica medicare (r) facility · fee schedule · outpatient | $69 | $72 | $56 | 78% | — | $4 – $164 |
| 8 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $70 | $73 | $57 | 78% | — | $4 – $166 |
| 9 | Blue Cross Blue Shield bc medicare (n) facility · fee schedule · outpatient | $72 | $75 | $59 | 78% | — | $4 – $171 |
| 10 | Bcbs Mn bc state health plan (n) facility · other · outpatient | $97 | $97 | — | — | — | $97 – $97 |
| 11 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $95 | $99 | $77 | 78% | — | $5 – $226 |
| 12 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $96 | $100 | $78 | 78% | — | $5 – $228 |
| 13 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $103 | $107 | $83 | 78% | — | $5 – $244 |
| 14 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $104 | $108 | $84 | 78% | — | $5 – $246 |
| 15 | Bcbs Mn bc premier(n) facility · other · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 16 | Medica medica ubh pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $124 | $129 | $101 | 78% | — | $6 – $294 |
| 17 | Cigna hpi cigna (n) facility · other · outpatient | $127 | $132 | $103 | 78% | — | $7 – $301 |
| 18 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $131 | $136 | $106 | 78% | — | $7 – $309 |
| 19 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $131 | $136 | $106 | 78% | — | $7 – $309 |
| 20 | Medica medica ubh (n) facility · percent of total billed charges · outpatientfrom % of charges | $131 | $136 | $106 | 78% | — | $7 – $309 |
| 21 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $132 | $137 | $107 | 78% | — | $7 – $311 |
| 22 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $133 | $138 | $108 | 78% | — | $7 – $314 |
| 23 | Blue Cross Blue Shield bc aehp (n) facility · other · outpatient | $147 | $147 | — | — | — | $147 – $147 |
| 24 | Bcbs Mn bc high value/performance network (n) facility · other · outpatient | $158 | $158 | — | — | — | $158 – $158 |
Last updated: Jun 16, 2026
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