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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
$426.58 / $575.44 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $575.44 / $977.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $602.56 / $2,137.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $575.44 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $1,548.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $562.34 / $1,318.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $524.81 / $831.76