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Replacement Pretibial Shell

South Dakota rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$603

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $603 for this service. The price depends on where it is billed: about $603 from a physician practice, and about $603 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$603$398 to $676
FacilityA hospital or hospital-owned outpatient department$603$490 to $692

How much rates vary

Facilitymedian $603 · 10th to 90th $417 to $871Professionalmedian $603 · 10th to 90th $389 to $832
$200.0$500.0$1.0K$2.0Kfacility $603professional $603

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$436.52
Typical High
$645.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$691.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$831.76
Medica
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$645.65
Typical High
$1,202.26
Medica
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$426.58
Typical High
$3,715.35
Midlands
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$676.08
Typical High
$676.08
Midlands
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$1,148.15
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$645.65
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$323.59
Typical High
$467.74
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$426.58
Typical High
$676.08
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56

Where South Dakota sits

The same service costs 3.5 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $603 · 3rd of 51
HI $813DC $234

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.