go back

New Mexico rates for HCPCS L1840

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.14 / $624.14 / $624.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622.15 / $958.50 / $3,985.02
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 / $1,392.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,018.25 / $1,272.82 / $1,909.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.63 / $333.63 / $956.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.05 / $732.96 / $1,437.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,173.99 / $1,173.99 / $1,381.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.24 / $516.79 / $778.47