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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

Facilitymedian $759 · 10th–90th $501–$1,9500%20%10th90th$759Professionalmedian $575 · 10th–90th $457–$1,6600%20%40%10th90th$575$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $758.58 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $549.54 / $1,548.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $2,344.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $1,862.09
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $954.99 / $954.99
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $1,174.90
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,949.84 / $4,570.88
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,174.90 / $2,238.72
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $741.31
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $707.95 / $741.31
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,122.02 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $512.86 / $2,818.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $741.31 / $1,949.84
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $707.95 / $831.76
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $707.95 / $741.31