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North Dakota 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
$758.58 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $575.44 / $1,445.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,202.26 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,548.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $933.25 / $5,011.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $537.03 / $1,096.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $1,584.89 / $1,584.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $549.54 / $1,148.15