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South Carolina 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
$932.18 / $932.18 / $932.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$894.41 / $932.18 / $1,649.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,090.00 / $1,429.32 / $2,042.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.70 / $1,186.93 / $1,310.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.46 / $1,132.59 / $1,186.93
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$838.10 / $1,350.00 / $2,957.87
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.00 / $1,059.00 / $1,138.00
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
$626.40 / $893.69 / $1,204.77