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South Carolina 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
$712.56 / $712.56 / $712.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.86 / $712.56 / $1,260.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$825.00 / $1,015.33 / $1,526.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$633.38 / $840.60 / $928.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.64 / $829.42 / $855.20
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.65 / $1,019.00 / $2,261.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$800.00 / $800.00 / $859.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.83 / $972.83 / $972.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.83 / $680.20 / $865.54