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Replacement Pretibial Shell

New Mexico rates for HCPCS L4130

Replace pretibial shell

Rates data updated October 2026.

How much does Replacement Pretibial Shell cost?

$316

Typical negotiated rate. In New Mexico, October 2026.

Insurers have agreed to pay about $316 for this service. The price depends on where it is billed: about $316 from a physician practice, and about $372 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$316$275 to $490
FacilityA hospital or hospital-owned outpatient department$372$182 to $468

How much rates vary

Facilitymedian $372 · 10th to 90th $182 to $501Professionalmedian $316 · 10th to 90th $257 to $646
$200$500$1Kfacility $372professional $316

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
Aetna
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$489.78
Typical High
$489.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$275.42
Typical High
$371.54
Molina
Setting
Professional
Modifier
None
Typical Low
$524.81
Median
$645.65
Typical High
$977.24
Providence
Setting
Facility
Modifier
None
Typical Low
$181.97
Median
$371.54
Typical High
$501.19
Providence
Setting
Professional
Modifier
None
Typical Low
$275.42
Median
$275.42
Typical High
$891.25
United
Setting
Facility
Modifier
None
Typical Low
$645.65
Median
$645.65
Typical High
$758.58
United
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$281.84
Typical High
$416.87

Where New Mexico sits

The same service costs 3.0 times more in Hawaii than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Mexico· 39th of 51

$316

HI $813VT $275

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.