go back

New Hampshire rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $575 · 10th–90th $316–$6760%20%40%10th90th$575Professionalmedian $380 · 10th–90th $245–$6460%20%10th90th$380$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $316.23 / $645.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $602.56 / $691.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $275.42 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $363.08 / $489.78
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $794.33