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Illinois 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

Facilitymedian $575 · 10th–90th $398–$2,1380%20%10th90th$575Professionalmedian $501 · 10th–90th $380–$7760%20%10th90th$501$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $457.09 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,479.11 / $7,585.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $501.19 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $741.31
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $977.24 / $1,584.89
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $537.03 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $537.03 / $831.76