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California rates for HCPCS L4130

Replace pretibial shell

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.70 / $335.70 / $2,150.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.43 / $335.70 / $2,150.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.93 / $1,050.21 / $2,365.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.72 / $340.43 / $546.73
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.20 / $882.31 / $1,575.56
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $988.82 / $2,303.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.57 / $373.57 / $398.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $272.70 / $384.78
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.36 / $390.43 / $819.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.15 / $521.67 / $1,132.78
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,172.33 / $3,539.94 / $3,539.94
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,688.99 / $3,688.99 / $4,192.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,335.45 / $1,335.45 / $1,335.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.02 / $644.07 / $745.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $373.57 / $709.34
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,406.62 / $1,406.62 / $1,406.62
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.36 / $553.11 / $596.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.06 / $253.19 / $276.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.82 / $278.85 / $745.25