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Utah rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $363 · 10th–90th $182–$6460%20%40%10th90th$363Professionalmedian $398 · 10th–90th $182–$3,2360%10%10th90th$398$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $363.08 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $467.74 / $616.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $645.65 / $645.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $724.44
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $758.58
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $660.69 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $275.42 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $281.84 / $489.78