go back

Idaho rates for HCPCS L1845

Knee Orthosis 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 (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.84 / $691.92 / $837.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$577.54 / $632.51 / $632.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.73 / $632.51 / $741.71
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.57 / $673.62 / $956.30
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.67 / $908.49 / $956.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $705.74 / $840.50
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$837.37 / $933.89 / $1,400.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.41 / $669.41 / $1,004.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.74 / $459.39 / $707.90