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Idaho 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
Professional
Modifier
Low / Median / High Price
$295.62 / $664.95 / $677.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$636.97 / $636.97 / $636.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.99 / $464.99 / $679.05
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.96 / $584.98 / $664.95
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.48 / $555.73 / $595.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $653.17 / $776.07
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$578.62 / $578.62 / $867.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.19 / $435.07 / $625.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.69 / $481.81 / $769.49