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Missouri 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
$399.18 / $399.18 / $771.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$396.46 / $413.70 / $631.44
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.00 / $671.54 / $671.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.20 / $677.46 / $2,978.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.29 / $685.32 / $900.02
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 / $464.99 / $706.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$413.70 / $631.44 / $3,153.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.51 / $536.70 / $1,307.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.75 / $536.70 / $865.95