go back

Arizona rates for HCPCS L1840

Knee orthosis (KO), derotation, medial-lateral, anterior cruciate ligament, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.47 / $558.99 / $988.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.61 / $1,309.92 / $2,368.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$906.52 / $1,208.69 / $1,646.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$732.96 / $732.96 / $732.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.05 / $535.05 / $1,313.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.63 / $922.86 / $5,476.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.61 / $516.79 / $778.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.61 / $516.79 / $778.47