go back

Wisconsin rates for HCPCS L4130

Replace pretibial shell

Facilitymedian $589 · 10th–90th $479$1,0720%20%40%10th90th$589Professionalmedian $417 · 10th–90th $275$8910%20%10th90th$417$0.5$2.0$10.0$50.0$200.0$1.0K

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 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $302.00 / $501.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $1,348.96 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $831.76 / $1,122.02
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $478.63 / $724.44
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $575.44 / $741.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $575.44 / $2,951.21
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $323.59 / $676.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $338.84
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $660.69 / $1,148.15
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $891.25 / $1,737.80
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $1,174.90 / $3,548.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $549.54 / $3,715.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $323.59 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $288.40 / $512.86