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Pennsylvania 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 $1,738 · 10th–90th $447–$3,1620%10%20%10th90th$1,738Professionalmedian $537 · 10th–90th $447–$9120%20%40%10th90th$537$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
$446.68 / $1,737.80 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $524.81 / $758.58
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $812.83
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $891.25 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $630.96
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $2,238.72
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $776.25 / $1,122.02
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $5,011.87 / $5,248.07
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $870.96 / $933.25
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $524.81 / $891.25
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $1,819.70
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $776.25 / $1,047.13
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $1,258.93 / $1,445.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $549.54 / $1,023.29