go back

Tennessee 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
$847.34 / $847.34 / $925.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.64 / $872.53 / $1,585.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.14 / $1,695.06 / $1,695.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.63 / $1,186.93 / $1,186.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.46 / $866.46 / $1,186.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,983.85 / $9,309.60 / $11,345.23
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,732.79 / $11,732.79 / $13,815.00
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 / $920.00 / $1,346.21