Replacement lacer for custom leg brace at Fairview Maple Grove Surgery Center

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.

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Provider: anthropic
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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Replace non-molded calf lace

Maple Grove, MN

See all hospitals reporting HCPCS L4055 →

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Pricing by billing methodology

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $337 is 5% above the median hospital's median price ($322), higher than 67% of the 816 hospitals reporting HCPCS L4055. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L4055 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 5 payers, 22 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 federal fee schedule · outpatient	$258	$258	—	—	—	$258 – $258
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$263	$263	—	—	—	$263 – $263
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$263	$263	—	—	—	$263 – $263
4	Blue Cross Blue Shield federal fee schedule · both	$279	$279	—	—	—	$279 – $279
5	Blue Cross Blue Shield commercial fee schedule · both	$284	$284	—	—	—	$284 – $284
6	Medica accessability fee schedule · both	$294	$294	—	—	—	$294 – $294
7	Medica medicaid fee schedule · both	$294	$294	—	—	—	$294 – $294
8	Medica ma non-snp fee schedule · both	$319	$319	—	—	—	$319 – $319
9	Medica ma snp fee schedule · both	$319	$319	—	—	—	$319 – $319
10	Medica prime solution fee schedule · both	$319	$319	—	—	—	$319 – $319
11	Medica vantage fee schedule · both	$319	$319	—	—	—	$319 – $319
12	Blue Cross Blue Shield medicaid fee schedule · both	$320	$320	—	—	—	$320 – $320
13	Ucare mhcp fee schedule · both	$328	$328	—	—	—	$328 – $328
14	Cigna commercial fee schedule · both	$394	$394	$34	9%	—	$360 – $429
15	Ucare ifp with fairview fee schedule · outpatient	$530	$530	—	—	—	$530 – $530
16	Medica bold fee schedule · both	$555	$555	—	—	—	$555 – $555
17	Medica choice without / elect fee schedule · both	$616	$616	—	—	—	$616 – $616
18	Medica city of st paul / essential uplan fee schedule · both	$616	$616	—	—	—	$616 – $616
19	Medica choice with fee schedule · both	$638	$638	—	—	—	$638 – $638
20	UnitedHealthcare commercial fee schedule · both	$645	$645	—	—	—	$645 – $645
21	Ucare ifp fee schedule · outpatient	$706	$706	—	—	—	$706 – $706
22	Cigna commercial fee schedule · outpatient	$828	$828	$72	9%	—	$756 – $900

Last updated: May 18, 2026

Compare to other hospitals

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.