go back

Washington 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
$244.43 / $291.89 / $855.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.85 / $428.86 / $621.84
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.84 / $570.00 / $570.00
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$430.29 / $841.46 / $2,424.52
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.75 / $472.65 / $3,450.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$465.67 / $465.67 / $489.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.94 / $339.94 / $489.93
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.03 / $844.75 / $1,956.69
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.03 / $822.27 / $1,380.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.57 / $525.08 / $577.58
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.19 / $451.52 / $613.30
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$365.75 / $472.65 / $860.58
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.75 / $472.65 / $653.14
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$430.29 / $430.29 / $485.70
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.87 / $381.14 / $544.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.64 / $348.45 / $569.51
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.88 / $461.15 / $461.15