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 | $775 – $824 | $388 | $969 |
| Deaconess Medical Center | $688 – $707 | $388 | $969 |
| Harborview Medical Center | — | $931 | $1,330 |
| Mary Bridge Children's Hospital | $634 – $775 | $388 | $969 |
| MultiCare Auburn Medical Center | $572 – $707 | $388 | $969 |
| MultiCare Covington Medical Center | $572 – $707 | $388 | $969 |
| MultiCare Good Samaritan Hospital | $572 – $707 | $388 | $969 |
| MultiCare Valley Hospital | $698 | $388 | $969 |
| Seattle Children's Hospital | $1,297 – $2,307 | $2,403 | $2,403 |
| Tacoma General Allenmore Hospital | $572 – $707 | $388 | $969 |
| University of Washington Medical Ctr | — | $1,175 | $1,679 |
| Yakima Valley Memorial | $543 | $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)