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
PR LO FLEX W/O RIGID STAYS PRE
Dubuque, IA
See all hospitals reporting HCPCS L0628 →Price type
The Finley Hospital’s median price of $65 is 5% below the median hospital's median price ($69), higher than 36% of the 1,047 hospitals reporting HCPCS L0628. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 15 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 | UnitedHealthcare hmo fee schedule · both | $50 | $50 | — | — | — | $50 – $50 |
| 2 | UnitedHealthcare ppo fee schedule · both | $50 | $50 | — | — | — | $50 – $50 |
| 3 | Aetna hmo fee schedule · outpatient | $62 | $62 | — | — | — | $62 – $62 |
| 4 | Aetna ppo fee schedule · outpatient | $62 | $62 | — | — | — | $62 – $62 |
| 5 | Aetna medicare advantage case rate · outpatient | $63 | $63 | — | — | — | $63 – $63 |
| 6 | Molina medicare advantage case rate · outpatient | $63 | $63 | — | — | — | $63 – $63 |
| 7 | Wellmark medicare advantage case rate · outpatient | $63 | $63 | — | — | — | $63 – $63 |
| 8 | Humana medicare advantage case rate · outpatient | $65 | $65 | — | — | — | $65 – $65 |
| 9 | UnitedHealthcare medicare advantage case rate · outpatient | $65 | $65 | — | — | — | $65 – $65 |
| 10 | Wellmark commercial fee schedule · both | $80 | $80 | — | — | — | $80 – $80 |
| 11 | Wellmark hmo fee schedule · both | $80 | $80 | — | — | — | $80 – $80 |
| 12 | Wellmark ppo fee schedule · both | $80 | $80 | — | — | — | $80 – $80 |
| 13 | Cigna commercial fee schedule · both | $104 | $104 | — | — | — | $104 – $104 |
| 14 | Aetna hmo fee schedule · both | $112 | $112 | — | — | — | $112 – $112 |
| 15 | Aetna ppo fee schedule · both | $112 | $112 | — | — | — | $112 – $112 |
Last updated: Jan 28, 2026
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