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Vermont 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
Professional
Modifier
Low / Median / High Price
$776.25 / $1,047.13 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $870.96 / $1,174.90
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,778.28 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,122.02 / $1,202.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,380.38 / $3,981.07