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Mississippi 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
$635.87 / $635.87 / $1,013.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.14 / $645.79 / $1,013.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.00 / $941.00 / $941.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.00 / $941.00 / $941.00
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 / $461.73 / $632.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.26 / $527.87 / $844.97