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Washington, DC 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
$310.73 / $310.73 / $310.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.73 / $310.73 / $615.59
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.47 / $546.47 / $546.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.99 / $464.99 / $464.99
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.93 / $420.93 / $1,278.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.94 / $526.41 / $689.40