go back

Replacement Pretibial Shell

Massachusetts rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$490

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $490 for this service. The price depends on where it is billed: about $490 from a physician practice, and about $372 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 9 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$490$275 to $490
FacilityA hospital or hospital-owned outpatient department$372$245 to $776

How much rates vary

Facilitymedian $372 · 10th to 90th $245 to $2,951Professionalmedian $490 · 10th to 90th $245 to $741
$100$200$500$1K$2K$5Kfacility $372professional $490

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
$245.47
Median
$245.47
Typical High
$245.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$275.42
Typical High
$851.14
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$575.44
Typical High
$3,630.78
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$446.68
Typical High
$676.08
BCBS
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$977.24
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$371.54
Typical High
$389.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$446.68
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$741.31
Health New England
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$575.44
Typical High
$3,630.78
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$446.68
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$346.74
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$467.74
Typical High
$524.81

Where Massachusetts 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.

Massachusetts· 12th of 51

$490

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.