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California rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $324 · 10th–90th $257$1,4790%20%10th90th$324Professionalmedian $339 · 10th–90th $269$2,8840%20%10th90th$339$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $338.84 / $2,884.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $323.59 / $1,479.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $338.84 / $912.01
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $1,096.48 / $1,737.80
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,380.38 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $371.54 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $407.38 / $912.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $691.83 / $1,174.90
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,168.69 / $4,168.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $616.60 / $912.01
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $724.44
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $426.58 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $275.42 / $758.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $331.13 / $776.25