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Alaska rates for HCPCS L1844

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, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,814.88 / $1,814.88 / $1,814.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,186.93 / $1,186.93 / $1,186.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.46 / $1,186.93 / $1,265.32
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$576.95 / $576.95 / $576.95
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,012.69 / $2,251.75 / $3,177.93
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$576.95 / $576.95 / $1,186.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.46 / $1,265.32 / $2,273.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.98 / $2,025.83 / $2,642.39