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Michigan rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $724 · 10th–90th $331–$2,3440%20%10th90th$724Professionalmedian $331 · 10th–90th $251–$5750%20%10th90th$331$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $309.03 / $501.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,737.80 / $3,311.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $602.56
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $323.59 / $467.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $1,096.48 / $1,230.27
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $467.74 / $707.95
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $467.74 / $758.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $275.42 / $416.87