go back

Replacement Pretibial Shell

Illinois rates for HCPCS L4130

Replace pretibial shell

Rates data updated October 2026.

How much does Replacement Pretibial Shell cost?

$372

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $372 for this service. The price depends on where it is billed: about $316 from a physician practice, and about $794 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$316$288 to $525
FacilityA hospital or hospital-owned outpatient department$794$661 to $1,349

How much rates vary

Facilitymedian $794 · 10th to 90th $372 to $3,388Professionalmedian $316 · 10th to 90th $275 to $708
$200$500$1K$2K$5Kfacility $794professional $316

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$295.12
Typical High
$588.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$295.12
Typical High
$467.74
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$147.91
Median
$147.91
Typical High
$234.42
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$58.88
Median
$58.88
Typical High
$93.33
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$44.67
Median
$44.67
Typical High
$70.79
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$29.51
Median
$29.51
Typical High
$46.77
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$977.24
Typical High
$3,981.07
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$446.68
Typical High
$446.68
Cigna
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$275.42
Typical High
$371.54
Hally Health
Setting
Professional
Modifier
None
Typical Low
$457.09
Median
$588.84
Typical High
$794.33
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Molina
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$436.52
Typical High
$478.63
United
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$588.84
Typical High
$912.01
United
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$288.40
Typical High
$691.83

Where Illinois 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.

Illinois· 22nd of 51

$372

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.