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Maine 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
Professional
Modifier
Low / Median / High Price
$638.04 / $886.37 / $886.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,298.80 / $1,682.72 / $3,119.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$803.13 / $803.13 / $828.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.60 / $840.60 / $965.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.64 / $613.64 / $840.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,182.33 / $1,182.33 / $1,182.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$755.88 / $869.27 / $886.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.68 / $728.53 / $1,675.37