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Replacement Pretibial Shell

Georgia rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$389

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $389 for this service. The price depends on where it is billed: about $380 from a physician practice, and about $676 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$380$309 to $550
FacilityA hospital or hospital-owned outpatient department$676$309 to $933

How much rates vary

Facilitymedian $676 · 10th to 90th $309 to $2,455Professionalmedian $380 · 10th to 90th $275 to $646
$1.0$10.0$100.0$1.0K$10.0Kfacility $676professional $380

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
$309.03
Median
$309.03
Typical High
$812.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$316.23
Typical High
$575.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,584.89
Typical High
$2,454.71
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$549.54
Typical High
$812.83
CareSource
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
CareSource
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$794.33
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$676.08
Typical High
$1,071.52
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$275.42
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$316.23
Typical High
$588.84

Where Georgia 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.

Georgia $389 · 13th 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.