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-afo cal
Cedar Rapids, IA
See all hospitals reporting HCPCS L4110 →Price type
St Luke's Methodist Hospital’s median price of $107 is about the same as the median hospital's median price ($106), higher than 52% of the 818 hospitals reporting HCPCS L4110. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 17 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 | UnitedHealthcare hmo fee schedule · both | $51 | $51 | — | — | — | $51 – $51 |
| 2 | UnitedHealthcare ppo fee schedule · both | $51 | $51 | — | — | — | $51 – $51 |
| 3 | Wellmark commercial fee schedule · both | $96 | $96 | — | — | — | $96 – $96 |
| 4 | Wellmark hmo fee schedule · both | $96 | $96 | — | — | — | $96 – $96 |
| 5 | Wellmark ppo fee schedule · both | $96 | $96 | — | — | — | $96 – $96 |
| 6 | Aetna medicare advantage case rate · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 7 | Molina medicare advantage case rate · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 8 | Wellmark medicare advantage case rate · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 9 | Humana medicare advantage case rate · outpatient | $107 | $107 | — | — | — | $107 – $107 |
| 10 | UnitedHealthcare medicare advantage case rate · outpatient | $107 | $107 | — | — | — | $107 – $107 |
| 11 | Aetna hmo fee schedule · both | $114 | $114 | — | — | — | $114 – $114 |
| 12 | Aetna ppo fee schedule · both | $114 | $114 | — | — | — | $114 – $114 |
| 13 | Cigna commercial fee schedule · both | $129 | $129 | — | — | — | $129 – $129 |
| 14 | UnitedHealthcare hmo fee schedule · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 15 | UnitedHealthcare ppo fee schedule · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 16 | Aetna hmo fee schedule · outpatient | $188 | $188 | — | — | — | $188 – $188 |
| 17 | Aetna ppo fee schedule · outpatient | $188 | $188 | — | — | — | $188 – $188 |
Last updated: Jan 28, 2026
See Replacement leather cuff for knee-ankle-foot orthosis pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.