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Texas rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $490 · 10th–90th $282$1,3800%10%10th90th$490Professionalmedian $309 · 10th–90th $269$4680%50%10th90th$309$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $302.00 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $660.69 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,168.69 / $4,168.69
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $501.19 / $870.96
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $309.03 / $676.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $354.81
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $489.78 / $870.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $389.05 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $338.84 / $398.11
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $660.69 / $660.69