go back

North Dakota 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
$691.92 / $691.92 / $691.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.39 / $691.92 / $701.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$889.22 / $1,051.36 / $1,077.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,170.00 / $1,181.70 / $1,485.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.71 / $701.27 / $4,802.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.88 / $510.01 / $1,009.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.26 / $474.46 / $765.65