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Mississippi 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
$609.12 / $609.12 / $970.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.06 / $623.54 / $970.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$842.28 / $842.28 / $842.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$842.28 / $842.28 / $842.28
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $516.01 / $809.44