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
HB OT-CSTM-EWHO W/NONTORSION JT-LBR/SPLY
Longmont, CO
See all hospitals reporting HCPCS L3764 →Price type
Longs Peak Hospital’s median price of $851 is 7% below the median hospital's median price ($920), higher than 22% of the 1,050 hospitals reporting HCPCS L3764. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 22 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 commercial percent of total billed charges · inpatientfrom % of charges | $668 | $668 | — | — | — | $668 – $668 |
| 2 | Anthem commercial percent of total billed charges · outpatientfrom % of charges | $668 | $686 | $124 | 18% | — | $525 – $903 |
| 3 | Anthem ppo percent of total billed charges · outpatientfrom % of charges | $774 | $774 | — | — | — | $774 – $774 |
| 4 | Anthem hmo/ppo percent of total billed charges · outpatientfrom % of charges | $808 | $808 | $143 | 18% | — | $665 – $952 |
| 5 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $844 | $844 | — | — | — | $844 – $844 |
| 6 | Aetna medicare advantage fee schedule · outpatient | $851 | $851 | — | — | — | $851 – $851 |
| 7 | Anthem medicare advantage fee schedule · outpatient | $851 | $851 | — | — | — | $851 – $851 |
| 8 | Cigna medicare advantage fee schedule · outpatient | $851 | $851 | — | — | — | $851 – $851 |
| 9 | Devoted medicare advantage fee schedule · outpatient | $851 | $851 | — | — | — | $851 – $851 |
| 10 | Humana medicare advantage fee schedule · outpatient | $851 | $851 | — | — | — | $851 – $851 |
| 11 | Kaiser medicare advantage fee schedule · outpatient | $851 | $851 | — | — | — | $851 – $851 |
| 12 | UnitedHealthcare medicare advantage fee schedule · outpatient | $851 | $851 | — | — | — | $851 – $851 |
| 13 | UnitedHealthcare select rates percent of total billed charges · outpatientfrom % of charges | $923 | $923 | — | — | — | $923 – $923 |
| 14 | Cigna colorado rockies percent of total billed charges · outpatientfrom % of charges | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 15 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 16 | UnitedHealthcare broad networks percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 17 | Cigna local plus/surefit/connect percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 18 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 19 | Phcs commercial percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 20 | Cigna broad networks percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 21 | First Health commercial percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 22 | First Health commercial percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
Last updated: Nov 1, 2025
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