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Connecticut 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
$476.87 / $476.87 / $476.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.11 / $489.71 / $561.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$760.39 / $981.15 / $1,122.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.09 / $557.09 / $587.69
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 / $461.73 / $632.51
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$637.75 / $637.75 / $637.75
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.75 / $686.81 / $981.15
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$570.97 / $570.97 / $570.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.26 / $489.49 / $815.81