go back

Alaska 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
Professional
Modifier
Low / Median / High Price
$549.54 / $588.84 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $457.09 / $741.31
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $812.83 / $912.01
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $933.25 / $2,951.21
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $912.01 / $954.99
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $912.01 / $933.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $977.24
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $630.96 / $912.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $707.95 / $2,344.23