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Arkansas rates for HCPCS L1851

Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$604.08 / $604.08 / $604.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.22 / $604.08 / $615.59
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.96 / $360.96 / $837.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.63 / $812.16 / $902.40
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$714.98 / $714.98 / $714.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.98 / $714.98 / $714.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$571.98 / $636.97 / $712.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.99 / $636.97 / $672.36
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.10 / $415.10 / $963.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $519.57 / $769.49