go back

Replacement Pretibial Shell

Washington rates for HCPCS L4130

Replace pretibial shell

Rates data updated July 2026.

How much does Replacement Pretibial Shell cost?

$646

Typical negotiated rate. In Washington, July 2026.

Insurers have agreed to pay about $646 for this service. The price depends on where it is billed: about $617 from a physician practice, and about $724 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 10 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$617$417 to $724
FacilityA hospital or hospital-owned outpatient department$724$617 to $1,096

How much rates vary

Facilitymedian $724 · 10th to 90th $501 to $1,445Professionalmedian $617 · 10th to 90th $282 to $1,148
$10.0$100.0$1.0Kfacility $724professional $617

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
$501.19
Median
$501.19
Typical High
$1,202.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$501.19
Typical High
$3,235.94
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$724.44
Typical High
$741.31
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$831.76
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
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$870.96
Typical High
$2,137.96
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$812.83
Typical High
$1,288.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$575.44
Typical High
$630.96
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$724.44
Typical High
$741.31
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$645.65
Typical High
$741.31
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$1,096.48
Typical High
$1,479.11
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$724.44
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$741.31
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$645.65
Typical High
$831.76
United
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$758.58
Typical High
$912.01
United
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$323.59
Typical High
$537.03
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$338.84
Typical High
$645.65

Where Washington 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.

Washington $646 · 2nd 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.