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North Dakota 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
$795.17 / $795.17 / $795.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.75 / $615.59 / $795.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.26 / $713.27 / $731.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.13 / $755.61 / $950.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$438.74 / $664.95 / $3,153.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.42 / $562.11 / $883.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.02 / $538.64 / $870.83