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North Carolina rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $575 · 10th–90th $245–$1,3180%10%20%10th90th$575Professionalmedian $398 · 10th–90th $269–$5750%20%40%10th90th$398$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$575.44 / $575.44 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $346.74 / $575.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $371.54 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $446.68
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $323.59 / $380.19
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $575.44 / $912.01
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $281.84 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $323.59 / $467.74
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $4,168.69