go back

Replacement Pretibial Shell

Montana rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

Facilitymedian $631 · 10th–90th $398$7760%20%40%10th90th$631Professionalmedian $490 · 10th–90th $182$1,2300%10%20%10th90th$490$100.0$200.0$500.0$1.0K$2.0K

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
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$302.00
Typical High
$3,235.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$676.08
Typical High
$676.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$676.08
Typical High
$676.08
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$630.96
Typical High
$1,230.27
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$630.96
Typical High
$1,230.27
Providence
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$602.56
Typical High
$776.25
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$501.19
Typical High
$707.95
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$346.74
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$281.84
Typical High
$426.58