go back

Replacement Pretibial Shell

Oregon rates for HCPCS L4130

Replace pretibial shell

Rates data updated October 2026.

How much does Replacement Pretibial Shell cost?

$589

Typical negotiated rate. In Oregon, October 2026.

Insurers have agreed to pay about $589 for this service. The price depends on where it is billed: about $447 from a physician practice, and about $676 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$447$275 to $724
FacilityA hospital or hospital-owned outpatient department$676$589 to $741

How much rates vary

Facilitymedian $676 · 10th to 90th $513 to $776Professionalmedian $447 · 10th to 90th $275 to $832
$100$200$500$1K$2Kfacility $676professional $447

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$338.84
Median
$446.68
Typical High
$446.68
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
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$575.44
Median
$1,288.25
Typical High
$1,621.81
Moda Health
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$562.34
Typical High
$758.58
Moda Health
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$691.83
Typical High
$758.58
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$588.84
Median
$676.08
Typical High
$741.31
Pacific Source
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Providence
Setting
Facility
Modifier
None
Typical Low
$371.54
Median
$467.74
Typical High
$758.58
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$275.42
Typical High
$724.44
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$1,174.90
Typical High
$2,884.03
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$776.25
Median
$831.76
Typical High
$831.76
United
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$912.01
Typical High
$1,230.27
United
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$281.84
Typical High
$549.54
8 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$165.96
Median
$223.87
Typical High
$223.87
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$67.61
Median
$89.13
Typical High
$89.13
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$50.12
Median
$67.61
Typical High
$67.61
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$33.88
Median
$44.67
Typical High
$44.67
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$186.21
Median
$223.87
Typical High
$223.87
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$74.13
Median
$89.13
Typical High
$89.13
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$56.23
Median
$67.61
Typical High
$67.61
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$37.15
Median
$44.67
Typical High
$44.67

Where Oregon 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.

Oregon· 10th of 51

$589

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.