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
Replace non-molded calf lace
Ottawa, KS
See all hospitals reporting HCPCS L4055 →Price type
Adventhealth Ottawa’s median price of $416 is 29% above the median hospital's median price ($322), higher than 81% of the 816 hospitals reporting HCPCS L4055. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 3 payers, 3 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield blue choice ppo fee schedule · outpatient | $321 | $321 | — | — | — | $321 – $321 |
| 2 | Aetna medicare managed care - hmo/ppo fee schedule · outpatient | $328 | $328 | — | — | — | $328 – $328 |
| 3 | Oscar individual plan hmo fee schedule · outpatient | $558 | $558 | — | — | — | $558 – $558 |
Last updated: Apr 1, 2026
See Replacement lacer for custom leg brace pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.