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Maine rates for HCPCS L1830

Knee orthosis (KO), immobilizer, canvas longitudinal, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $87.10 / $630.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $58.88 / $194.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $87.10 / $100.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $67.61
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $75.86
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $87.10 / $630.96
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.48 / $58.88 / $190.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $48.98 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $61.66 / $89.13