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Replacement Pretibial Shell

Iowa rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$389

Typical negotiated rate. In Iowa, July 2026.

Insurers have agreed to pay about $389 for this service. The price depends on where it is billed: about $389 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$389$309 to $603
FacilityA hospital or hospital-owned outpatient department$479$389 to $891

How much rates vary

Facilitymedian $479 · 10th to 90th $295 to $1,549Professionalmedian $389 · 10th to 90th $234 to $676
$1.0$10.0$100.0$1.0Kfacility $479professional $389

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
$302.00
Median
$398.11
Typical High
$467.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$389.05
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$676.08
Typical High
$831.76
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$602.56
Typical High
$645.65
Medica
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$741.31
Typical High
$2,951.21
Medica
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$371.54
Typical High
$1,023.29
Midlands
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$724.44
Typical High
$870.96
Midlands
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$1,023.29
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$467.74
Typical High
$1,202.26
United
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$309.03
Typical High
$588.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$602.56
Typical High
$602.56

Where Iowa 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.

Iowa $389 · 14th 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.