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Replacement Pretibial Shell

Indiana rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$316

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $316 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 5 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$288 to $339
FacilityA hospital or hospital-owned outpatient department$589$339 to $589

How much rates vary

Facilitymedian $589 · 10th to 90th $288 to $661Professionalmedian $309 · 10th to 90th $269 to $513
$200$500$1Kfacility $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
$288.40
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$295.12
Typical High
$512.86
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$588.84
Typical High
$741.31
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$338.84
Typical High
$588.84
CareSource
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$851.14
Typical High
$977.24
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$371.54
Typical High
$588.84
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$288.40
Typical High
$426.58

Where Indiana sits

The same service costs 3.5 times more in Hawaii than in Washington, DC. 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.

Indiana· 36th of 51

$316

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.