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
BLLN MOLDG OCCL 10-37X4X90
Monroe, LA
See all hospitals reporting HCPCS C2628 →Price type
Brfhh Monroe, Llc’s median price of $392 is 70% below the median hospital's median price ($1.3k), higher than 13% of the 1,338 hospitals reporting HCPCS C2628. 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, 13 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 | Bcbs La all payor fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Aetna Better Health all payor other · outpatient | $220 | $322 | $234 | 73% | — | $14 – $731 |
| 3 | Amerihealth Caritas all payor other · outpatient | $220 | $322 | $234 | 73% | — | $14 – $731 |
| 4 | Humana all payor other · outpatient | $220 | $322 | $234 | 73% | — | $14 – $731 |
| 5 | UnitedHealthcare all payor other · outpatient | $220 | $322 | $234 | 73% | — | $14 – $731 |
| 6 | UnitedHealthcare all payor percent of total billed charges · outpatientfrom % of charges | $461 | $645 | $475 | 74% | — | $26 – $1.6k |
| 7 | Cigna all payor other · inpatient | $688 | $1.0k | $732 | 73% | — | $45 – $2.3k |
| 8 | Cigna all payor other · outpatient | $688 | $1.0k | $732 | 73% | — | $45 – $2.3k |
| 9 | Aetna all payor other · inpatient | $894 | $1.3k | $952 | 73% | — | $59 – $3.0k |
| 10 | Aetna all payor other · outpatient | $894 | $1.3k | $952 | 73% | — | $59 – $3.0k |
| 11 | First Health all payor other · inpatient | $894 | $1.3k | $952 | 73% | — | $59 – $3.0k |
| 12 | First Health all payor other · outpatient | $894 | $1.3k | $952 | 73% | — | $59 – $3.0k |
| 13 | MultiPlan all payor other · outpatient | $963 | $1.4k | $1.0k | 73% | — | $63 – $3.2k |
Last updated: Apr 1, 2026
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