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Montana rates for HCPCS L1833

Knee orthosis (KO), adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.57 / $458.57 / $458.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.79 / $428.86 / $471.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$597.39 / $597.39 / $597.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$465.67 / $643.98 / $643.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$465.67 / $643.98 / $643.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.22 / $465.67 / $643.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.85 / $485.70 / $643.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.64 / $341.71 / $541.94