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Mississippi 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
$485.47 / $485.47 / $773.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$438.73 / $604.08 / $773.72
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$973.03 / $973.03 / $973.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$799.86 / $799.86 / $799.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.86 / $799.86 / $799.86
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 / $636.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $525.34 / $858.57