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Montana 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 $1,072 · 10th–90th $708–$1,3490%20%10th90th$1,072Professionalmedian $631 · 10th–90th $363–$1,1480%10%10th90th$631$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $616.60 / $933.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,148.15 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,148.15 / $1,148.15
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,071.52 / $2,089.30
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,071.52 / $2,089.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,023.29 / $1,318.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $870.96 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $549.54 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $478.63 / $741.31