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Replacement Pretibial Shell

Hawaii rates for HCPCS L4130

Replace pretibial shell

Rates data updated October 2026.

How much does Replacement Pretibial Shell cost?

$813

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $813 for this service. Most negotiated rates run $631 to $851.

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.

How much rates vary

Facilitymedian $631 · 10th to 90th $372 to $631Professionalmedian $813 · 10th to 90th $501 to $871
$500$1Kfacility $631professional $813

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$630.96
Typical High
$630.96
Cigna
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$870.96
Typical High
$870.96
HMSA
Setting
Professional
Modifier
None
Typical Low
$812.83
Median
$812.83
Typical High
$851.14
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$549.54
Median
$812.83
Typical High
$1,071.52
United
Setting
Professional
Modifier
None
Typical Low
$562.34
Median
$870.96
Typical High
$870.96
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$501.19
Median
$501.19
Typical High
$501.19

Where Hawaii sits

The same service costs 3.0 times more in Hawaii than in Vermont. 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.

Hawaii· 1st of 51

$813

HI $813VT $275

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.