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Replacement Pretibial Shell

Rhode Island rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

Facilitymedian $933 · 10th–90th $324$1,2880%10%20%10th90th$933Professionalmedian $295 · 10th–90th $245$3800%20%10th90th$295$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$269.15
Typical High
$331.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$1,122.02
Typical High
$1,288.25
BCBS
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$295.12
Typical High
$489.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$346.74
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$316.23
Typical High
$467.74