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Louisiana 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
$714.68 / $758.66 / $1,021.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$671.22 / $758.65 / $919.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,150.96 / $1,966.24 / $2,763.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.91 / $938.86 / $938.86
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$829.42 / $840.60 / $840.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.64 / $829.42 / $840.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.58 / $627.77 / $967.54