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 HFO FLEXION GLOVE W ELSTC FNGR CNTRL PREFAB O
Ulm, MN
See all hospitals reporting HCPCS L3912 →Price type
Allina Health Systems’s median price of $117 is about the same as the median hospital's median price ($118), higher than 48% of the 1,155 hospitals reporting HCPCS L3912. 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 | $32 | $32 | $22 | 69% | — | $10 – $55 |
| 2 | Medica medica pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $51 | $51 | $35 | 69% | — | $16 – $86 |
| 3 | Bcbs Mn bc pmap (n) facility · other · outpatient | $69 | $69 | — | — | — | $69 – $69 |
| 4 | Medicaid medicaid ma (n) facility · other · outpatient | $70 | $70 | $49 | 69% | — | $21 – $119 |
| 5 | Medica medica medicare (r) facility · fee schedule · outpatient | $71 | $71 | $49 | 69% | — | $22 – $120 |
| 6 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $72 | $72 | $50 | 69% | — | $22 – $122 |
| 7 | Blue Cross Blue Shield bc medicare (n) facility · fee schedule · outpatient | $74 | $74 | $52 | 69% | — | $23 – $126 |
| 8 | Aetna allina aetna medicare (n) facility · fee schedule · outpatient | $78 | $78 | $32 | 41% | — | $46 – $110 |
| 9 | Medicare medicare (n) facility · fee schedule · outpatient | $82 | $82 | $34 | 41% | — | $48 – $116 |
| 10 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $98 | $98 | $68 | 69% | — | $30 – $166 |
| 11 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $99 | $99 | $69 | 69% | — | $30 – $168 |
| 12 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $106 | $106 | $74 | 69% | — | $32 – $179 |
| 13 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $107 | $107 | $74 | 69% | — | $33 – $181 |
| 14 | Medica medica ubh pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $128 | $128 | $89 | 69% | — | $39 – $217 |
| 15 | Cigna hpi cigna (n) facility · other · outpatient | $131 | $131 | $91 | 69% | — | $40 – $222 |
| 16 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $134 | $134 | $93 | 69% | — | $41 – $228 |
| 17 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $134 | $134 | $93 | 69% | — | $41 – $228 |
| 18 | Medica medica ubh (n) facility · percent of total billed charges · outpatientfrom % of charges | $134 | $134 | $93 | 69% | — | $41 – $228 |
| 19 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $135 | $135 | $94 | 69% | — | $41 – $229 |
| 20 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $137 | $137 | $95 | 69% | — | $42 – $232 |
| 21 | Bcbs Mn bc state health plan (n) facility · other · outpatient | $170 | $170 | — | — | — | $170 – $170 |
| 22 | Bcbs Mn bc premier(n) facility · other · outpatient | $218 | $218 | — | — | — | $218 – $218 |
| 23 | Blue Cross Blue Shield bc aehp (n) facility · other · outpatient | $256 | $256 | — | — | — | $256 – $256 |
| 24 | Bcbs Mn bc high value/performance network (n) facility · other · outpatient | $275 | $275 | — | — | — | $275 – $275 |
Last updated: Jun 16, 2026
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