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Indiana 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
Facility
Modifier
Low / Median / High Price
$908.13 / $908.13 / $1,834.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$873.20 / $943.06 / $996.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,449.50 / $1,642.15 / $1,834.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$876.37 / $1,095.47 / $1,480.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.55 / $2,018.29 / $2,752.22
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,559.59 / $2,018.29 / $2,476.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,186.93 / $1,186.93 / $1,834.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.46 / $1,186.93 / $1,882.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,193.78 / $1,193.78 / $1,193.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.79 / $893.69 / $1,344.87