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Replacement Pretibial Shell

Virginia rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

Facilitymedian $575 · 10th–90th $282$7410%20%40%10th90th$575Professionalmedian $309 · 10th–90th $234$5750%20%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
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$338.84
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$616.60
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$707.95
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$354.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$575.44
Typical High
$812.83
Medcost
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$380.19
Typical High
$575.44
Medcost
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$371.54
Typical High
$758.58
Medcost
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$331.13
Typical High
$724.44
Sentara
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$478.63
Typical High
$1,288.25
Sentara
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$478.63
Typical High
$1,288.25
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$275.42
Typical High
$758.58
United
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$281.84
Typical High
$457.09