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New Mexico 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
$648.41 / $648.41 / $648.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.41 / $831.48 / $4,841.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$792.24 / $1,056.32 / $1,258.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.60 / $840.60 / $840.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.64 / $840.60 / $840.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,549.62 / $1,937.03 / $2,905.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$405.35 / $405.35 / $993.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.64 / $840.60 / $1,549.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.91 / $627.88 / $945.81