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Replacement Pretibial Shell

Connecticut rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$302

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $372 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 6 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$295$245 to $355
FacilityA hospital or hospital-owned outpatient department$372$331 to $575

How much rates vary

Facilitymedian $372 · 10th to 90th $269 to $575Professionalmedian $295 · 10th to 90th $234 to $589
$200$500$1K$2Kfacility $372professional $295

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$269.15
Typical High
$588.84
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$575.44
Typical High
$691.83
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$354.81
Typical High
$741.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$575.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$363.08
Typical High
$363.08
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$416.87
Typical High
$630.96
Health New England
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$275.42
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$281.84
Typical High
$489.78

Where Connecticut sits

The same service costs 3.5 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Connecticut· 43rd of 51

$302

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.