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Nationwide rates for HCPCS L1845

Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.48 / $565.69 / $701.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.64 / $541.40 / $762.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.27 / $1,102.60 / $1,940.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.09 / $557.09 / $767.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.51 / $632.51 / $632.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.73 / $632.51 / $741.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.60 / $495.53 / $790.77