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Oklahoma 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
$498.95 / $498.95 / $735.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.47 / $498.95 / $553.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$923.99 / $923.99 / $923.99
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 / $632.51 / $632.51
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.57 / $633.77 / $4,802.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.26 / $502.97 / $1,043.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.26 / $459.39 / $659.05