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Hawaii 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
$794.33 / $954.99 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,905.46 / $2,691.53
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,238.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $2,137.96 / $2,511.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,122.02 / $1,148.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,479.11 / $2,344.23