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
Dubuque, IA
See all hospitals reporting HCPCS L4055 →Price type
The Finley Hospital’s median price of $333 is 3% above the median hospital's median price ($322), higher than 66% 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: 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.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare hmo fee schedule · both | $161 | $161 | — | — | — | $161 – $161 |
| 2 | UnitedHealthcare ppo fee schedule · both | $161 | $161 | — | — | — | $161 – $161 |
| 3 | Wellmark commercial fee schedule · both | $306 | $306 | — | — | — | $306 – $306 |
| 4 | Wellmark hmo fee schedule · both | $306 | $306 | — | — | — | $306 – $306 |
| 5 | Wellmark ppo fee schedule · both | $306 | $306 | — | — | — | $306 – $306 |
| 6 | Aetna hmo fee schedule · outpatient | $322 | $322 | — | — | — | $322 – $322 |
| 7 | Aetna ppo fee schedule · outpatient | $322 | $322 | — | — | — | $322 – $322 |
| 8 | Aetna medicare advantage case rate · outpatient | $328 | $328 | — | — | — | $328 – $328 |
| 9 | Molina medicare advantage case rate · outpatient | $328 | $328 | — | — | — | $328 – $328 |
| 10 | Wellmark medicare advantage case rate · outpatient | $328 | $328 | — | — | — | $328 – $328 |
| 11 | Humana medicare advantage case rate · outpatient | $338 | $338 | — | — | — | $338 – $338 |
| 12 | UnitedHealthcare medicare advantage case rate · outpatient | $338 | $338 | — | — | — | $338 – $338 |
| 13 | Aetna hmo fee schedule · both | $360 | $360 | — | — | — | $360 – $360 |
| 14 | Aetna ppo fee schedule · both | $360 | $360 | — | — | — | $360 – $360 |
| 15 | Cigna commercial fee schedule · both | $409 | $409 | — | — | — | $409 – $409 |
| 16 | UnitedHealthcare hmo fee schedule · outpatient | $482 | $482 | — | — | — | $482 – $482 |
| 17 | UnitedHealthcare ppo fee schedule · outpatient | $482 | $482 | — | — | — | $482 – $482 |
Last updated: Jan 28, 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.