go back

Wyoming 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
Professional
Modifier
Low / Median / High Price
$612.05 / $612.05 / $957.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,067.33 / $1,067.33 / $1,067.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,067.33 / $1,067.33 / $1,067.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.03 / $702.03 / $1,183.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.48 / $512.48 / $702.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.46 / $481.81 / $534.90