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Replacement Pretibial Shell

Ohio rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$331

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $331 for this service. The price depends on where it is billed: about $316 from a physician practice, and about $589 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 8 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$316$282 to $398
FacilityA hospital or hospital-owned outpatient department$589$479 to $646

How much rates vary

Facilitymedian $589 · 10th to 90th $309 to $933Professionalmedian $316 · 10th to 90th $275 to $603
$1.0$10.0$100.0$1.0Kfacility $589professional $316

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
$309.03
Median
$478.63
Typical High
$549.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$309.03
Typical High
$398.11
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$616.60
Typical High
$1,258.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$346.74
Typical High
$758.58
CareSource
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$562.34
Typical High
$794.33
CareSource
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$588.84
Typical High
$891.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$371.54
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$389.05
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$354.81
Typical High
$501.19
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$660.69
Typical High
$1,202.26
United
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$467.74
Typical High
$645.65
United
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$281.84
Typical High
$426.58

Where Ohio 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.

Ohio $331 · 32nd 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.