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Louisiana 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
$1,016.13 / $1,078.66 / $1,453.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$904.30 / $1,078.66 / $1,186.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,636.43 / $2,795.60 / $3,929.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,115.99 / $1,334.89 / $1,334.89
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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 / $1,186.93
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 / $892.57 / $1,383.22