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Replacement Pretibial Shell

Michigan rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$339

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $331 from a physician practice, and about $759 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 7 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$331$309 to $575
FacilityA hospital or hospital-owned outpatient department$759$331 to $1,514

How much rates vary

Facilitymedian $759 · 10th to 90th $331 to $2,344Professionalmedian $331 · 10th to 90th $269 to $589
$1.0$10.0$100.0$1.0Kfacility $759professional $331

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
$331.13
Median
$331.13
Typical High
$331.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$331.13
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$1,737.80
Typical High
$3,311.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$575.44
Typical High
$602.56
CareSource
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$323.59
Typical High
$371.54
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$1,096.48
Typical High
$1,230.27
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$467.74
Typical High
$707.95
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$467.74
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$275.42
Typical High
$426.58

Where Michigan 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.

Michigan $339 · 30th 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.