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Replacement Pretibial Shell

Utah rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$355

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $355 for this service. The price depends on where it is billed: about $355 from a physician practice, and about $275 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$355$257 to $661
FacilityA hospital or hospital-owned outpatient department$275$182 to $646

How much rates vary

Facilitymedian $275 · 10th to 90th $182 to $646Professionalmedian $355 · 10th to 90th $182 to $3,236
$50.0$100.0$200.0$500.0$1.0K$2.0Kfacility $275professional $355

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Aetna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$288.40
Typical High
$3,235.94
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$467.74
Typical High
$616.60
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$645.65
Typical High
$645.65
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$457.09
Typical High
$831.76
Select Health
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Select Health
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$660.69
Typical High
$758.58
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$660.69
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$281.84
Typical High
$426.58

Where Utah 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.

Utah $355 · 22nd 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.