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Ohio rates for HCPCS L4130

Replace pretibial shell

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.18 / $310.18 / $945.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.14 / $310.18 / $359.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.27 / $635.25 / $1,645.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.72 / $327.32 / $750.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.13 / $577.50 / $789.04
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.25 / $577.50 / $1,236.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.57 / $373.57 / $770.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $272.70 / $373.57
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.57 / $373.57 / $373.57
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.70 / $373.57 / $373.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.97 / $336.84 / $441.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.61 / $276.36 / $462.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.07 / $279.12 / $418.52