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 lacer, for custom fabricated orthosis only
LARGO, FL
See all hospitals reporting HCPCS L4055 →Price type
Hca Florida Largo Hospital’s median price of $323 is about the same as the median hospital's median price ($322), higher than 53% 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, 11 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 | Humana tricare fee schedule · outpatient | $298 | $298 | — | — | — | $298 – $298 |
| 2 | Caresource tricare fee schedule · outpatient | $307 | $307 | — | — | — | $307 – $307 |
| 3 | Devoted mcr fee schedule · outpatient | $307 | $307 | — | — | — | $307 – $307 |
| 4 | UnitedHealthcare mgmcd fee schedule · outpatient | $307 | $307 | — | — | — | $307 – $307 |
| 5 | Blue Cross Blue Shield mcrppo fee schedule · outpatient | $313 | $313 | — | — | — | $313 – $313 |
| 6 | Blue Cross Blue Shield mgmcrhmo fee schedule · outpatient | $313 | $313 | — | — | — | $313 – $313 |
| 7 | UnitedHealthcare mcr fee schedule · outpatient | $313 | $313 | — | — | — | $313 – $313 |
| 8 | Humana mgmcrppo fee schedule · outpatient | $323 | $323 | — | — | — | $323 – $323 |
| 9 | WellCare mcr fee schedule · outpatient | $323 | $323 | — | — | — | $323 – $323 |
| 10 | Cigna Healthspring mcr fee schedule · outpatient | $329 | $329 | — | — | — | $329 – $329 |
| 11 | Humana mgmcrhmo fee schedule · outpatient | $338 | $338 | — | — | — | $338 – $338 |
Last updated: Mar 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.