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
Macon, GA
See all hospitals reporting HCPCS L4055 →Price type
Central Georgia Rehabilitation LLC’s median price of $307 is 4% below the median hospital's median price ($322), higher than 26% 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: 7 payers, 9 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 | Aetna medicare advantage fee schedule · outpatient | $301 | $301 | — | — | — | $301 – $301 |
| 2 | Anthem medicare advantage fee schedule · outpatient | $301 | $301 | — | — | — | $301 – $301 |
| 3 | Humana medicare advantage fee schedule · outpatient | $301 | $301 | — | — | — | $301 – $301 |
| 4 | UnitedHealthcare medicare advantage fee schedule · outpatient | $301 | $301 | — | — | — | $301 – $301 |
| 5 | Caresource medicare advantage fee schedule · outpatient | $307 | $307 | — | — | — | $307 – $307 |
| 6 | Clover medicare advantage fee schedule · outpatient | $307 | $307 | — | — | — | $307 – $307 |
| 7 | Humana hmo/pos fee schedule · both | $432 | $432 | — | — | — | $432 – $432 |
| 8 | Humana ppo fee schedule · both | $432 | $432 | — | — | — | $432 – $432 |
| 9 | Kaiser commercial fee schedule · both | $563 | $563 | — | — | — | $563 – $563 |
Last updated: Nov 19, 2025
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