go back

Utah rates for HCPCS L1831

Knee orthosis (KO), locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $102.33 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $194.98 / $1,513.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $199.53 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $208.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $263.03 / $338.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $316.23 / $549.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $257.04 / $371.54
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $354.81 / $363.08
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $363.08 / $426.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $154.88 / $177.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $158.49 / $229.09