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
Repl Met Band Kafo-Afo Calf/
Low
$41
Average
$123
Median
$93
High
$317
Filter by billing methodology
Prices here combine facility and professional fees. See them separately →Experimental
Reflects a negotiated percentage of total billed charges.
Showing only prices reported under the percent of billed charges methodology. Choose another in the filter above to change the chart. 24 hospitals; the 90th percentile is 2.5× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Hospital for Special Surgery White Plains, NY | $208 | $208 | — | — | — | $208 – $208 |
| 2 | Children's Healthcare of Atlanta Atlanta, GA | $250 | $256 | $58 | 23% | — | $151 – $360 |
| 3 | Hospital for Special Surgery New York, NY | $88 | $98 | $28 | 29% | — | $71 – $208 |
| 4 | Hospital for Special Surgery Water Mill, NY | $88 | $98 | $28 | 29% | — | $71 – $208 |
| 5 | Hospital for Special Surgery New York, NY | $208 | $208 | — | — | — | $208 – $208 |
| 6 | Hospital for Special Surgery Fresh Meadows, NY | $208 | $208 | — | — | — | $208 – $208 |
| 7 | Hmh Hospitals Corporation Hackensack, NJ | $107 | $105 | $33 | 31% | — | $28 – $151 |
| 8 | Hmh Hospitals Corporation Red Bank, NJ | $78 | $84 | $31 | 37% | — | $28 – $132 |
| 9 | Hmh Hospitals Corporation Edison, NJ | $87 | $93 | $32 | 34% | — | $28 – $155 |
| 10 | The University of Texas Southwestern Medical Center at Dallas Dallas, TX | $305 | $317 | $53 | 17% | — | $239 – $392 |
Ask Claude or any MCP client for HCPCS L4090 pricing at a specific hospital — see how to connect.