go back

California 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
$615.59 / $615.59 / $3,044.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.21 / $615.59 / $892.60
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.04 / $540.54 / $885.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$681.48 / $934.39 / $2,378.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.87 / $685.32 / $769.49
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.60 / $634.33 / $2,474.16
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.51 / $840.73 / $1,339.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$636.97 / $636.97 / $712.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.99 / $464.99 / $712.60
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.48 / $672.58 / $807.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.49 / $619.54 / $1,345.31
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,266.78 / $3,153.85 / $3,153.85
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,494.50 / $4,494.50 / $4,856.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $70.00 / $1,469.05
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.96 / $584.98 / $695.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.99 / $558.40 / $681.53
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,991.60 / $1,991.60 / $1,991.60
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.98 / $672.58 / $874.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.22 / $481.81 / $1,012.44