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Arizona 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
$812.83 / $977.24 / $2,089.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,445.44 / $3,019.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,398.83 / $4,570.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $870.96 / $1,174.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,584.89 / $9,332.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $891.25 / $11,748.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $1,174.90 / $1,905.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $891.25 / $1,348.96