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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
$933.25 / $933.25 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $954.99 / $1,659.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,905.46 / $2,238.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $1,174.90 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $870.96 / $2,137.96
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,096.48 / $1,230.27
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,479.11 / $3,019.95
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,174.90 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $933.25 / $1,202.26