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Replacement Pretibial Shell

Montana rates for HCPCS L4130

Replace pretibial shell

Rates data updated October 2026.

How much does Replacement Pretibial Shell cost?

$676

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $676 for this service. The price depends on where it is billed: about $617 from a physician practice, and about $676 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$617$282 to $676
FacilityA hospital or hospital-owned outpatient department$676$661 to $37,154

How much rates vary

Facilitymedian $676 · 10th to 90th $417 to $38,019Professionalmedian $617 · 10th to 90th $79 to $724
$100$500$2K$10K$50Kfacility $676professional $617

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$302.00
Typical High
$645.65
Cigna
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$676.08
Typical High
$676.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$549.54
Median
$676.08
Typical High
$676.08
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$489.78
Median
$812.83
Typical High
$38,018.94
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$660.69
Median
$724.44
Typical High
$39,810.72
Providence
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$676.08
Typical High
$676.08
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$501.19
Typical High
$676.08
United
Setting
Professional
Modifier
None
Typical Low
$257.04
Median
$281.84
Typical High
$467.74

Where Montana sits

The same service costs 3.0 times more in Hawaii than in Vermont. 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.

Montana· 3rd of 51

$676

HI $813VT $275

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.