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Michigan 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 $1,585 · 10th–90th $575–$3,3880%20%40%10th90th$1,585Professionalmedian $575 · 10th–90th $457–$1,0000%20%40%10th90th$575$1.0$5.0$20.0$100.0$500.0$2.0K$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
$575.44 / $1,584.89 / $1,584.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $549.54 / $794.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $3,019.95 / $5,754.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,071.52
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $630.96 / $1,148.15
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,819.70 / $2,137.96
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $812.83 / $1,230.27
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $707.95 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $831.76 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $478.63 / $724.44