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Missouri rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $501 · 10th–90th $324–$1,1750%20%10th90th$501Professionalmedian $331 · 10th–90th $275–$5750%20%10th90th$331$0.5$2.0$10.0$50.0$200.0$1.0K

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
$323.59 / $323.59 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $323.59 / $549.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $2,187.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $338.84 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $501.19 / $2,951.21
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $309.03 / $3,715.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $501.19 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $288.40 / $467.74