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Alabama 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
$980.30 / $980.30 / $980.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.05 / $609.12 / $980.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.40 / $674.40 / $674.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.03 / $702.03 / $1,081.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.48 / $702.03 / $946.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $481.81 / $740.18