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New York 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
$398.11 / $758.58 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $549.54 / $1,584.89
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $691.83 / $691.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $2,344.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $1,862.09
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $954.99 / $954.99
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,659.59 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $457.09 / $1,174.90
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,949.84 / $4,570.88
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,230.27 / $2,290.87
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $741.31
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $707.95 / $741.31
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,122.02 / $1,122.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $575.44 / $1,258.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $575.44 / $977.24
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $707.95 / $831.76
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $707.95 / $741.31