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Minnesota 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
Facility
Modifier
Low / Median / High Price
$701.27 / $701.27 / $701.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.45 / $608.35 / $701.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$864.59 / $1,009.29 / $1,405.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$807.43 / $958.83 / $1,009.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.51 / $3,114.00 / $8,648.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,170.00 / $1,240.20 / $1,485.90
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,848.74 / $2,987.73 / $6,810.13
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,170.00 / $1,170.00 / $1,204.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.47 / $1,009.29 / $4,802.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.88 / $529.62 / $1,072.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.26 / $482.50 / $1,072.36