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Georgia 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
$538.84 / $1,669.16 / $3,492.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.66 / $645.36 / $901.39
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$585.90 / $839.64 / $839.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,134.65 / $1,588.51 / $4,164.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.09 / $943.44 / $1,811.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$857.90 / $964.45 / $2,099.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$964.45 / $964.45 / $964.45
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 / $1,170.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$862.33 / $1,134.65 / $1,576.55
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$939.24 / $1,451.56 / $2,099.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.38 / $553.74 / $1,108.06