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New Mexico 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
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,071.52 / $1,819.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,513.56 / $1,778.28
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 / $2,691.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,862.09 / $2,818.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,412.54 / $2,238.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $870.96 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,000.00 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $891.25 / $1,348.96