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Massachusetts 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

Facilitymedian $1,175 · 10th–90th $398–$1,7380%10%20%10th90th$1,175Professionalmedian $646 · 10th–90th $427–$1,1750%20%10th90th$646$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $537.03 / $1,348.96
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $4,897.79
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $758.58 / $1,174.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,288.25 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $630.96 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $741.31
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,288.25
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $4,897.79
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $758.58 / $1,174.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $512.86 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $660.69 / $870.96