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Minnesota 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
$1,274.86 / $1,274.86 / $1,274.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.78 / $1,274.86 / $1,471.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,571.76 / $1,834.81 / $2,554.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,467.85 / $1,743.07 / $1,834.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,186.93 / $5,661.06 / $15,723.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,127.00 / $2,254.62 / $2,701.29
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,360.90 / $5,431.51 / $12,380.40
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,127.00 / $2,127.00 / $2,188.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.26 / $1,834.81 / $9,309.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.79 / $915.37 / $2,201.77
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 / $962.81 / $1,927.07