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Replacement Pretibial Shell

Missouri rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$339

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $501 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 6 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$339$316 to $427
FacilityA hospital or hospital-owned outpatient department$501$363 to $631

How much rates vary

Facilitymedian $501 · 10th to 90th $324 to $1,047Professionalmedian $339 · 10th to 90th $282 to $741
$1.0$10.0$100.0$1.0Kfacility $501professional $339

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
$323.59
Median
$323.59
Typical High
$371.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$331.13
Typical High
$3,235.94
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$2,187.76
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$338.84
Typical High
$575.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$630.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$371.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$501.19
Typical High
$2,951.21
Medica
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$309.03
Typical High
$3,715.35
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$501.19
Typical High
$630.96
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$295.12
Typical High
$489.78

Where Missouri 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.

Missouri $339 · 25th 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.