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Minnesota 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
$530.75 / $530.75 / $530.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$438.73 / $615.59 / $677.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.98 / $831.19 / $1,208.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.42 / $853.13 / $898.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$636.97 / $1,979.09 / $5,496.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.13 / $793.01 / $950.12
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.96 / $1,898.84 / $4,328.16
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.13 / $748.13 / $765.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$438.74 / $645.20 / $3,153.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $539.04 / $1,085.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $538.02 / $1,085.59