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Colorado 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
$612.05 / $612.05 / $612.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.37 / $580.03 / $818.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,092.96 / $1,228.05 / $2,229.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.00 / $565.54 / $584.04
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 / $512.48 / $1,151.13
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.04 / $612.05 / $1,374.99
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.04 / $311.04 / $311.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$797.86 / $1,366.20 / $2,164.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$437.48 / $481.81 / $725.77