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Massachusetts 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
$462.40 / $462.40 / $462.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.96 / $479.02 / $917.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$534.41 / $1,685.56 / $3,153.85
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.75 / $672.24 / $814.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,133.00 / $1,362.55 / $1,754.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$682.63 / $1,044.42 / $1,323.57
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 / $636.97 / $748.13
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.45 / $860.45 / $903.47
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$732.15 / $732.15 / $732.15
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.56 / $732.15 / $732.15
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,329.63 / $3,153.85 / $3,153.85
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.75 / $526.41 / $840.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.75 / $533.52 / $860.45