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Vermont rates for HCPCS L1845

Knee Orthosis 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 (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.45 / $478.80 / $552.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$793.79 / $793.79 / $793.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.51 / $632.51 / $721.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.73 / $632.51 / $741.71
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.51 / $632.51 / $721.15
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.73 / $632.51 / $741.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.32 / $582.87 / $1,134.27