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Replacement Pretibial Shell

Idaho rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$537

Typical negotiated rate. In Idaho, July 2026.

Insurers have agreed to pay about $537 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $661 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 8 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$501$295 to $724
FacilityA hospital or hospital-owned outpatient department$661$525 to $724

How much rates vary

Facilitymedian $661 · 10th to 90th $324 to $933Professionalmedian $501 · 10th to 90th $234 to $832
$1.0$10.0$100.0$1.0Kfacility $661professional $501

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
Professional
Modifier
Global
Typical Low
$234.42
Median
$446.68
Typical High
$645.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$707.95
Typical High
$1,202.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$831.76
Typical High
$831.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$467.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$371.54
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$588.84
Typical High
$758.58
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$724.44
Typical High
$758.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$537.03
Typical High
$660.69
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$724.44
Typical High
$724.44
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$831.76
Select Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$758.58
Typical High
$1,148.15
Select Health
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$724.44
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$0.45
Median
$323.59
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$281.84
Typical High
$398.11

Where Idaho 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.

Idaho $537 · 9th 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.