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 leath cuff kafo prox th
Minneapolis, MN
See all hospitals reporting HCPCS L4100 →Price type
Fairview Health Services’s median price of $133 is about the same as the median hospital's median price ($132), higher than 52% of the 807 hospitals reporting HCPCS L4100. 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, 40 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 | Bcbs Mn pmap fee schedule · outpatient | $55 | $55 | — | — | — | $55 – $55 |
| 2 | Bcbs Mn aware federal fee schedule · both | $114 | $114 | — | — | — | $114 – $114 |
| 3 | Bcbs Mn national transplant fee schedule · both | $114 | $114 | — | — | — | $114 – $114 |
| 4 | Bcbs Mn aware/blue plus fee schedule · both | $116 | $116 | — | — | — | $116 – $116 |
| 5 | Medica managed medicaid/accessability fee schedule · both | $119 | $119 | — | — | — | $119 – $119 |
| 6 | Optum medicaid transplant fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 7 | Sanford Health Plan medicare advantage fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 8 | UnitedHealthcare medicare advantage fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 9 | WellCare medicare advantage fee schedule · outpatient | $120 | $120 | — | — | — | $120 – $120 |
| 10 | Ucare medicare advantage/msho fee schedule · outpatient | $122 | $122 | — | — | — | $122 – $122 |
| 11 | Bcbs Mn medicare advantage fee schedule · outpatient | $125 | $125 | — | — | — | $125 – $125 |
| 12 | Medica medicare advantage non-snp fee schedule · outpatient | $128 | $128 | — | — | — | $128 – $128 |
| 13 | Ucare government transplant fee schedule · outpatient | $129 | $129 | — | — | — | $129 – $129 |
| 14 | Ucare pmap fee schedule · outpatient | $129 | $129 | — | — | — | $129 – $129 |
| 15 | Medica medicare advantage non-snp fee schedule · both | $130 | $130 | — | — | — | $130 – $130 |
| 16 | Optum medicare transplant fee schedule · outpatient | $130 | $130 | — | — | — | $130 – $130 |
| 17 | Bcbs Mn pmap fee schedule · both | $130 | $130 | — | — | — | $130 – $130 |
| 18 | Bcbs Mn aware federal fee schedule · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 19 | Bcbs Mn national transplant fee schedule · outpatient | $131 | $131 | — | — | — | $131 – $131 |
| 20 | Medica msho/medicare advantage snp fee schedule · both | $132 | $132 | — | — | — | $132 – $132 |
| 21 | Bcbs Mn aware/blue plus fee schedule · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 22 | Ucare government transplant fee schedule · both | $133 | $133 | — | — | — | $133 – $133 |
| 23 | Ucare pmap fee schedule · both | $133 | $133 | — | — | — | $133 – $133 |
| 24 | Medica managed medicaid/accessability fee schedule · outpatient | $147 | $147 | — | — | — | $147 – $147 |
| 25 | Medica msho/medicare advantage snp fee schedule · outpatient | $159 | $159 | — | — | — | $159 – $159 |
Last updated: Feb 6, 2026
See Replacement leather cuff for knee-ankle-foot orthosis, upper thigh pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.