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Replacement Pretibial Shell

Colorado rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$363

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $363 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $479 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$339$275 to $363
FacilityA hospital or hospital-owned outpatient department$479$363 to $661

How much rates vary

Facilitymedian $479 · 10th to 90th $182 to $832Professionalmedian $339 · 10th to 90th $245 to $501
$1.0$10.0$100.0$1.0Kfacility $479professional $339

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$630.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$363.08
Typical High
$501.19
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$794.33
Typical High
$1,412.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$338.84
Typical High
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$588.84
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$489.78
Typical High
$831.76
Denver HMP
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$660.69
Typical High
$1,023.29
Select Health
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$1,202.26
Typical High
$1,380.38
Select Health
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$660.69
Typical High
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$323.59
Typical High
$660.69
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$281.84
Typical High
$416.87

Where Colorado sits

The same service costs 3.5 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Colorado $363 · 18th of 51
HI $813DC $234

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.