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
Cypress, TX
See all hospitals reporting HCPCS L4055 →Price type
Houston Methodist Cypress Hospital’s median price of $329 is 2% above the median hospital's median price ($322), higher than 61% 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, 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 managed care - hmo fee schedule · outpatient | $313 | $313 | — | — | — | $313 – $313 |
| 2 | Aetna medicare managed care - hmo/ppo fee schedule · outpatient | $318 | $318 | — | — | — | $318 – $318 |
| 3 | UnitedHealthcare medicare managed care - hmo fee schedule · outpatient | $319 | $319 | — | — | — | $319 – $319 |
| 4 | Cigna texas healthspring medicare managed care - hmo/ppo fee schedule · outpatient | $322 | $322 | — | — | — | $322 – $322 |
| 5 | Molina advantage medicare managed care plan fee schedule · outpatient | $329 | $329 | — | — | — | $329 – $329 |
| 6 | Devoted medicare managed care - hmo fee schedule · outpatient | $335 | $335 | — | — | — | $335 – $335 |
| 7 | Optum transplant medicare managed care plan fee schedule · outpatient | $610 | $610 | — | — | — | $610 – $610 |
| 8 | Molina exchange fee schedule · outpatient | $626 | $626 | — | — | — | $626 – $626 |
Last updated: Apr 1, 2026
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