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
Edmonds, WA
See all hospitals reporting HCPCS L4055 →Price type
Swedish Edmonds’s median price of $374 is 16% above the median hospital's median price ($322), higher than 73% of the 812 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: 6 payers, 9 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 | Kaiser medicare managed care plan fee schedule · outpatient | $312 | $312 | — | — | — | $312 – $312 |
| 2 | Aetna medicare managed care - hmo fee schedule · outpatient | $321 | $321 | — | — | — | $321 – $321 |
| 3 | Aetna medicare managed care - ppo fee schedule · outpatient | $324 | $324 | — | — | — | $324 – $324 |
| 4 | UnitedHealthcare medicare managed care plan fee schedule · outpatient | $327 | $327 | — | — | — | $327 – $327 |
| 5 | Humana choice care medicare managed care plan fee schedule · outpatient | $330 | $330 | — | — | — | $330 – $330 |
| 6 | Blue Cross Blue Shield regence medicare managed care plan fee schedule · outpatient | $337 | $337 | — | — | — | $337 – $337 |
| 7 | Cigna medicare managed care plan fee schedule · outpatient | $374 | $374 | — | — | — | $374 – $374 |
| 8 | Kaiser all commercial plans fee schedule · outpatient | $467 | $467 | — | — | — | $467 – $467 |
| 9 | Blue Cross Blue Shield premera lifewise exchange fee schedule · outpatient | $561 | $561 | — | — | — | $561 – $561 |
Last updated: Apr 1, 2026
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