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Iowa rates for HCPCS L1846

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, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$919.95 / $979.51 / $979.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.51 / $755.89 / $1,298.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$829.42 / $840.60 / $1,384.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$840.60 / $1,634.25 / $2,042.81
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.61 / $1,400.57 / $1,484.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$790.61 / $1,617.17 / $6,648.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.66 / $708.65 / $1,719.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.35 / $1,384.41 / $1,911.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,133.83 / $1,636.12 / $2,645.55
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,283.72 / $1,437.92 / $2,516.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.78 / $627.88 / $1,197.90
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,233.38 / $1,233.38 / $1,233.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$974.37 / $1,233.38 / $1,233.38