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 L0174 30X-39
Los Angeles, CA
See all hospitals reporting HCPCS L0174 →Price type
Dignity Community Care’s median price of $138 is 58% below the median hospital's median price ($325), higher than 14% of the 1,311 hospitals reporting HCPCS L0174. 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 | Molina medicaid|< 21 fee schedule · inpatient | $52 | $52 | $7 | 13% | — | $45 – $59 |
| 2 | Molina medicaid|> 21 fee schedule · inpatient | $52 | $52 | $7 | 13% | — | $45 – $59 |
| 3 | Anthem medicaid|all plans fee schedule · inpatient | $56 | $56 | $8 | 13% | — | $49 – $64 |
| 4 | Anthem commercial|exchange fee schedule · outpatient | $79 | $79 | $11 | 13% | — | $68 – $89 |
| 5 | Cigna commercial|all other plans fee schedule · inpatient | $92 | $92 | $12 | 13% | — | $80 – $105 |
| 6 | Cigna commercial|ppo fee schedule · inpatient | $92 | $92 | $12 | 13% | — | $80 – $105 |
| 7 | Blue Cross Blue Shield commercial|exchange fee schedule · inpatient | $99 | $99 | $13 | 13% | — | $86 – $112 |
| 8 | Aetna commercial|all other plans fee schedule · inpatient | $119 | $119 | $16 | 13% | — | $103 – $135 |
| 9 | Aetna commercial|hmo fee schedule · inpatient | $119 | $119 | $16 | 13% | — | $103 – $135 |
| 10 | Aetna commercial|ppo fee schedule · inpatient | $119 | $119 | $16 | 13% | — | $103 – $135 |
| 11 | Anthem commercial|all other plans fee schedule · outpatient | $122 | $122 | $16 | 13% | — | $105 – $138 |
| 12 | Anthem commercial|mcs fee schedule · outpatient | $122 | $122 | $16 | 13% | — | $105 – $138 |
| 13 | UnitedHealthcare commercial|ppo fee schedule · outpatient | $122 | $122 | $16 | 13% | — | $105 – $138 |
| 14 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $126 | $126 | $17 | 13% | — | $109 – $143 |
| 15 | First Health commercial|all plans fee schedule · inpatient | $155 | $155 | $21 | 13% | — | $135 – $176 |
| 16 | First Health commercial|all plans fee schedule · outpatient | $155 | $155 | $21 | 13% | — | $135 – $176 |
| 17 | Kaiser commercial|all plans fee schedule · inpatient | $158 | $158 | $21 | 13% | — | $137 – $179 |
| 18 | Kaiser commercial|all plans fee schedule · outpatient | $158 | $158 | $21 | 13% | — | $137 – $179 |
| 19 | Blue Cross Blue Shield medicare|promise fee schedule · outpatient | $169 | $169 | $23 | 13% | — | $146 – $191 |
| 20 | MultiPlan commercial|all plans fee schedule · inpatient | $178 | $178 | $24 | 13% | — | $154 – $201 |
| 21 | MultiPlan commercial|all plans fee schedule · outpatient | $178 | $178 | $24 | 13% | — | $154 – $201 |
| 22 | Cigna commercial|all other plans fee schedule · outpatient | $221 | $221 | $29 | 13% | — | $191 – $250 |
| 23 | Cigna commercial|ppo fee schedule · outpatient | $221 | $221 | $29 | 13% | — | $191 – $250 |
| 24 | Anthem medicaid|all plans fee schedule · outpatient | $225 | $225 | $30 | 13% | — | $195 – $255 |
| 25 | Molina medicaid|< 21 fee schedule · outpatient | $225 | $225 | $30 | 13% | — | $195 – $255 |
Last updated: Feb 28, 2026
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