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Florida 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
$450.34 / $499.07 / $571.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.86 / $532.94 / $951.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.60 / $706.50 / $815.19
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 / $702.03
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$667.48 / $667.48 / $667.48
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.50 / $667.48 / $1,086.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.77 / $347.35 / $382.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.03 / $531.05 / $691.21
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.35 / $347.35 / $578.59