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
ORTHO L5624 254X-331
Glendale, CA
See all hospitals reporting HCPCS L5624 →Price type
Dignity Community Care’s median price of $604 is 20% above the median hospital's median price ($504), higher than 71% of the 842 hospitals reporting HCPCS L5624. 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, 29 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 | Anthem medicaid|all plans fee schedule · outpatient | $269 | $269 | — | — | — | $269 – $269 |
| 2 | Molina medicaid|all plans fee schedule · outpatient | $301 | $301 | — | — | — | $301 – $301 |
| 3 | Kaiser medicaid|< 21 fee schedule · outpatient | $322 | $322 | — | — | — | $322 – $322 |
| 4 | Kaiser medicaid|> 21 fee schedule · outpatient | $322 | $322 | — | — | — | $322 – $322 |
| 5 | Molina medicaid|all plans fee schedule · inpatient | $381 | $381 | — | — | — | $381 – $381 |
| 6 | Anthem medicaid|all plans fee schedule · inpatient | $414 | $414 | — | — | — | $414 – $414 |
| 7 | Cigna commercial|all other plans fee schedule · inpatient | $497 | $497 | — | — | — | $497 – $497 |
| 8 | Cigna commercial|ppo fee schedule · inpatient | $497 | $497 | — | — | — | $497 – $497 |
| 9 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $844 | $844 | — | — | — | $844 – $844 |
| 10 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $861 | $861 | — | — | — | $861 – $861 |
| 11 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $861 | $861 | — | — | — | $861 – $861 |
| 12 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $910 | $910 | — | — | — | $910 – $910 |
| 13 | Kaiser commercial|all plans fee schedule · inpatient | $927 | $927 | — | — | — | $927 – $927 |
| 14 | Kaiser commercial|all plans fee schedule · outpatient | $927 | $927 | — | — | — | $927 – $927 |
| 15 | Blue Cross Blue Shield commercial|magellan fee schedule · inpatient | $993 | $993 | — | — | — | $993 – $993 |
| 16 | Blue Cross Blue Shield commercial|magellan fee schedule · outpatient | $993 | $993 | — | — | — | $993 – $993 |
| 17 | First Health commercial|all plans fee schedule · inpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 18 | First Health commercial|all plans fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 19 | Cigna commercial|all other plans fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 20 | Cigna commercial|ppo fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 21 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 22 | MultiPlan commercial|all plans fee schedule · inpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 23 | MultiPlan commercial|all plans fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 24 | Blue Cross Blue Shield commercial|all other plans fee schedule · inpatient | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 25 | Anthem commercial|mcs fee schedule · inpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
Last updated: Feb 28, 2026
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