HCPCS L4130
Replace pretibial shell
Current codeBelow Knee Orthotic24 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $655 – $5,083 | $388 | $969 |
| Deaconess Medical Center | $360 – $3,164 | $388 | $969 |
| Harborview Medical Center | $1,216 – $1,520 | $931 | $1,330 |
| Kadlec Regional Medical Center | $1,146 – $2,135 | — | — |
| Mary Bridge Children's Hospital | $626 – $5,579 | $388 | $969 |
| MultiCare Auburn Medical Center | $637 – $3,284 | $388 | $969 |
| MultiCare Covington Medical Center | $637 – $3,284 | $388 | $969 |
| MultiCare Good Samaritan Hospital | $637 – $3,284 | $388 | $969 |
| MultiCare Valley Hospital | $360 – $3,157 | $388 | $969 |
| Overlake Hospital Medical Center & Clinics | $697 – $2,091 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1,177 – $2,522 | — | — |
| Providence Centralia Hospital | $1,285 – $2,842 | — | — |
| Providence Regional Medical Center Everett | $912 – $1,764 | — | — |
| Providence St Peter Hospital | $646 – $2,482 | — | — |
| Seattle Children's Hospital | $1,297 – $2,307 | $2,403 | $2,403 |
| Swedish Edmonds Hospital | $1,140 – $2,788 | — | — |
| Swedish Issaquah | $1,140 – $1,688 | — | — |
| Swedish Medical Center | $1,140 – $2,715 | — | — |
| Swedish Medical Center / Cherry Hill | $1,140 – $2,715 | — | — |
| Tacoma General Allenmore Hospital | $637 – $3,284 | $388 | $969 |
| University of Washington Medical Ctr | $1,216 – $2,384 | $1,175 | $1,679 |
| Virginia Mason Medical Center | $728 – $2,644 | — | — |
| Wellfound Behavioral Health Hospital | $1,918 | — | — |
| Yakima Valley Memorial | $475 – $1,972 | $388 | $969 |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $760 (fee)