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North Carolina rates for HCPCS L4130

Replace pretibial shell

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.76 / $575.76 / $993.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.14 / $575.76 / $575.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$599.02 / $975.36 / $1,201.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.79 / $493.15 / $493.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.57 / $373.57 / $406.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $373.57 / $669.38
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.02 / $575.76 / $748.49
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.00 / $370.00 / $447.08
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.20 / $668.20 / $1,031.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.85 / $276.36 / $364.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.80 / $325.11 / $463.18
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,027.39 / $3,539.94 / $3,539.94
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,688.99 / $3,688.99 / $4,192.05