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Michigan 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

Facilitymedian $1,318 · 10th–90th $550–$4,3650%10%20%10th90th$1,318Professionalmedian $589 · 10th–90th $479–$1,0720%20%40%10th90th$589$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $575.44 / $831.76
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $831.76
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,235.94 / $6,165.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,148.15
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $707.95 / $1,202.26
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $2,041.74 / $2,290.87
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $870.96 / $1,318.26
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $758.58 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $891.25 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $512.86 / $758.58