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Washington, DC 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
$448.15 / $448.15 / $448.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.15 / $448.15 / $448.15
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.00 / $587.00 / $748.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.73 / $461.73 / $461.73
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.74 / $711.74 / $2,173.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.18 / $546.27 / $820.77