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
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Dubuque, IA
See all hospitals reporting HCPCS L6628 →Price type
The Finley Hospital’s median price of $729 is 6% above the median hospital's median price ($687), higher than 62% of the 818 hospitals reporting HCPCS L6628. 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, 17 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 | $352 | $352 | — | — | — | $352 – $352 |
| 2 | UnitedHealthcare ppo fee schedule · both | $352 | $352 | — | — | — | $352 – $352 |
| 3 | Wellmark commercial fee schedule · both | $692 | $692 | — | — | — | $692 – $692 |
| 4 | Wellmark hmo fee schedule · both | $692 | $692 | — | — | — | $692 – $692 |
| 5 | Wellmark ppo fee schedule · both | $692 | $692 | — | — | — | $692 – $692 |
| 6 | Aetna hmo fee schedule · outpatient | $706 | $706 | — | — | — | $706 – $706 |
| 7 | Aetna ppo fee schedule · outpatient | $706 | $706 | — | — | — | $706 – $706 |
| 8 | Aetna medicare advantage case rate · outpatient | $720 | $720 | — | — | — | $720 – $720 |
| 9 | Molina medicare advantage case rate · outpatient | $720 | $720 | — | — | — | $720 – $720 |
| 10 | Wellmark medicare advantage case rate · outpatient | $720 | $720 | — | — | — | $720 – $720 |
| 11 | Humana medicare advantage case rate · outpatient | $741 | $741 | — | — | — | $741 – $741 |
| 12 | UnitedHealthcare medicare advantage case rate · outpatient | $741 | $741 | — | — | — | $741 – $741 |
| 13 | Aetna hmo fee schedule · both | $789 | $789 | — | — | — | $789 – $789 |
| 14 | Aetna ppo fee schedule · both | $789 | $789 | — | — | — | $789 – $789 |
| 15 | Cigna commercial fee schedule · both | $896 | $896 | — | — | — | $896 – $896 |
| 16 | UnitedHealthcare hmo fee schedule · outpatient | $920 | $920 | — | — | — | $920 – $920 |
| 17 | UnitedHealthcare ppo fee schedule · outpatient | $920 | $920 | — | — | — | $920 – $920 |
Last updated: Jan 28, 2026
See Quick-disconnect hook adapter for upper limb prosthesis pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.