go back

Replacement Pretibial Shell

Rhode Island rates for HCPCS L4130

Replace pretibial shell

Rates data updated October 2026.

How much does Replacement Pretibial Shell cost?

$302

Typical negotiated rate. In Rhode Island, October 2026.

Insurers have agreed to pay about $302 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $1,023 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$295$275 to $331
FacilityA hospital or hospital-owned outpatient department$1,023$813 to $1,175

How much rates vary

Facilitymedian $1,023 · 10th to 90th $759 to $1,288Professionalmedian $295 · 10th to 90th $219 to $468
$200$500$1Kfacility $1,023professional $295

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
Professional
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$165.96
Median
$165.96
Typical High
$165.96
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$812.83
Median
$1,122.02
Typical High
$1,288.25
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$295.12
Typical High
$478.63
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
United
Setting
Facility
Modifier
None
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
United
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$316.23
Typical High
$467.74

Where Rhode Island 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.

Rhode Island· 45th of 51

$302

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.