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Replacement Pretibial Shell

New Mexico rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$339

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $427 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 5 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$339$295 to $490
FacilityA hospital or hospital-owned outpatient department$427$282 to $589

How much rates vary

Facilitymedian $427 · 10th to 90th $182 to $741Professionalmedian $339 · 10th to 90th $275 to $977
$20.0$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $427professional $339

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
$316.23
Median
$316.23
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$338.84
Typical High
$3,235.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$851.14
Molina
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$645.65
Typical High
$977.24
Providence
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$478.63
Typical High
$741.31
Providence
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$302.00
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$281.84
Typical High
$416.87

Where New Mexico 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.

New Mexico $339 · 27th 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.