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Replacement Pretibial Shell

North Carolina rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$501

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $501 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $575 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$501$324 to $575
FacilityA hospital or hospital-owned outpatient department$575$372 to $692

How much rates vary

Facilitymedian $575 · 10th to 90th $257 to $1,259Professionalmedian $501 · 10th to 90th $275 to $575
$1.0$10.0$100.0$1.0K$10.0Kfacility $575professional $501

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
$575.44
Median
$575.44
Typical High
$575.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$575.44
Typical High
$575.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$977.24
Typical High
$1,318.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$371.54
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$407.38
Medcost
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$323.59
Typical High
$380.19
Medcost
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$575.44
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$426.58
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$316.23
Typical High
$436.52
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$3,019.95
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$4,168.69

Where North Carolina 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.

North Carolina $501 · 11th 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.