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Wisconsin 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 $1,023 · 10th–90th $832–$1,8620%50%10th90th$1,023Professionalmedian $708 · 10th–90th $457–$1,7380%20%10th90th$708$1.0$5.0$20.0$100.0$500.0$2.0K

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
$512.86 / $512.86 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $537.03 / $1,000.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,698.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $2,344.23 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $1,479.11 / $1,949.84
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $831.76 / $1,258.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,348.96 / $1,698.24
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,000.00 / $4,786.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $537.03 / $1,148.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $616.60
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,148.15 / $2,041.74
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,548.82 / $2,884.03
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $2,041.74 / $4,786.30
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $933.25 / $5,495.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $512.86 / $1,023.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $891.25 / $2,089.30