Replace non-molded calf lace cost in Illinois

Replace non-molded calf lace · HCPCS L4055

Hospital City Cash price Negotiated range Payers
UnityPoint Health - Trinity Moline Rock Island not published $160.65 – $481.87 14
Advocate Good Samaritan Hospital Downers Grove not published $436.70 – $1,062.40 7
Advocate Condell Medical Center Libertyville not published $436.70 – $654.47 7
Advocate Christ Medical Center Oak Lawn not published $436.70 – $1,037.84 7
MercyOne Genesis Aledo Medical Center Aledo not published $380.00 – $380.00 1
Advocate Trinity Hospital Chicago not published $436.70 – $1,062.40 7
Advocate South Suburban Hospital Hazel Crest not published $436.70 – $1,066.24 7
Advocate Sherman Hospital Elgin not published $436.70 – $578.25 7
Advocate Childrens Hospital - Park Ridge Park Ridge not published $436.70 – $1,052.42 7
Advocate Illinois Masonic Medical Center Chicago not published $436.70 – $1,069.31 7