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 met band kafo-afo calf/
Cypress, TX
See all hospitals reporting HCPCS L4090 →Price type
Houston Methodist Cypress Hospital’s median price of $138 is 20% above the median hospital's median price ($115), higher than 73% of the 819 hospitals reporting HCPCS L4090. 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 | $131 | $131 | — | — | — | $131 – $131 |
| 2 | Aetna medicare managed care - hmo/ppo fee schedule · outpatient | $133 | $133 | — | — | — | $133 – $133 |
| 3 | UnitedHealthcare medicare managed care - hmo fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 4 | Cigna texas healthspring medicare managed care - hmo/ppo fee schedule · outpatient | $135 | $135 | — | — | — | $135 – $135 |
| 5 | Molina advantage medicare managed care plan fee schedule · outpatient | $138 | $138 | — | — | — | $138 – $138 |
| 6 | Devoted medicare managed care - hmo fee schedule · outpatient | $140 | $140 | — | — | — | $140 – $140 |
| 7 | Optum transplant medicare managed care plan fee schedule · outpatient | $256 | $256 | — | — | — | $256 – $256 |
| 8 | Molina exchange fee schedule · outpatient | $263 | $263 | — | — | — | $263 – $263 |
Last updated: Apr 1, 2026
See Replacement of metal bands on leg brace pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.