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Replacement Pretibial Shell

South Carolina rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

Facilitymedian $372 · 10th–90th $295$8320%20%10th90th$372Professionalmedian $324 · 10th–90th $257$5750%20%10th90th$324$20.0$50.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$323.59
Typical High
$575.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$602.56
Typical High
$676.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$575.44
Typical High
$831.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$371.54
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$676.08
Medcost
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$338.84
Medcost
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$467.74
Typical High
$1,047.13
Medcost
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$181.97
Molina
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$354.81
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$323.59
Typical High
$416.87