HCPCS L4130
Replace pretibial shell
Current codeBelow Knee Orthotic24 hospitals with prices
What Washington hospitals publish for this code
Other government program: TRICARE, VA, Indian Health Service, workers' compensation, or another public program.
| Hospital | Other government program rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $388 | $969 |
| Deaconess Medical Center | — | $388 | $969 |
| Harborview Medical Center | — | $931 | $1,330 |
| Mary Bridge Children's Hospital | — | $388 | $969 |
| MultiCare Auburn Medical Center | — | $388 | $969 |
| MultiCare Covington Medical Center | — | $388 | $969 |
| MultiCare Good Samaritan Hospital | — | $388 | $969 |
| MultiCare Valley Hospital | — | $388 | $969 |
| Seattle Children's Hospital | $985 | $2,403 | $2,403 |
| Tacoma General Allenmore Hospital | — | $388 | $969 |
| University of Washington Medical Ctr | — | $1,175 | $1,679 |
| Yakima Valley Memorial | — | $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)