go back

Rhode Island 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
Professional
Modifier
Low / Median / High Price
$305.45 / $518.75 / $581.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,387.21 / $1,873.59 / $2,218.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.85 / $640.85 / $887.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$567.52 / $632.51 / $632.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.73 / $632.51 / $632.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.35 / $524.47 / $815.81