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/
Arlington, TX
See all hospitals reporting HCPCS L4090 →Price type
AMH Cath Labs LLC’s median price of $138 is 20% above the median hospital's median price ($115), higher than 72% of the 815 hospitals reporting HCPCS L4090. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 8 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 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 2 | Humana medicare advantage case rate · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 3 | Humana medicare advantage ppo case rate · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 4 | Molina medicare advantage case rate · outpatient | $138 | $138 | — | — | — | $138 – $138 |
| 5 | WellCare medicare advantage hmo case rate · outpatient | $138 | $138 | — | — | — | $138 – $138 |
| 6 | WellCare medicare advantage mmp case rate · outpatient | $144 | $144 | — | — | — | $144 – $144 |
| 7 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $146 | $146 | — | — | — | $146 – $146 |
| 8 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $148 | $148 | — | — | — | $148 – $148 |
Last updated: Apr 21, 2026
See Replacement of metal bands on leg brace pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.