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Replacement Pretibial Shell

Illinois rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$309

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $309 for this service. The price depends on where it is billed: about $309 from a physician practice, and about $589 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$309$295 to $490
FacilityA hospital or hospital-owned outpatient department$589$295 to $1,047

How much rates vary

Facilitymedian $589 · 10th to 90th $295 to $2,951Professionalmedian $309 · 10th to 90th $275 to $603
$1.0$10.0$100.0$1.0Kfacility $589professional $309

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
$295.12
Median
$295.12
Typical High
$588.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$302.00
Typical High
$588.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$1,122.02
Typical High
$3,981.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$446.68
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$389.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$676.08
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$630.96
Typical High
$794.33
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Molina
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$467.74
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$288.40
Typical High
$489.78

Where Illinois 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.

Illinois $309 · 38th 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.