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Montana 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 $724 · 10th–90th $575–$1,7380%20%10th90th$724Professionalmedian $617 · 10th–90th $331–$9770%20%10th90th$617$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $616.60 / $794.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $954.99 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $954.99 / $954.99
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $1,258.93
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $1,258.93
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $660.69 / $1,047.13
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $630.96 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $549.54 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $478.63 / $776.25