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Nationwide rates for HCPCS L1843

Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$541.54 / $557.16 / $731.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.19 / $580.03 / $751.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,055.16 / $1,129.57 / $2,110.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.00 / $565.54 / $845.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.03 / $702.03 / $702.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.48 / $684.30 / $748.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.10 / $526.41 / $792.96