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North Dakota 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
$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