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New Jersey 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
$380.85 / $380.85 / $380.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.18 / $420.37 / $615.59
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 / $748.13
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.77 / $712.34 / $848.33
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.58 / $877.36 / $877.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.70 / $526.41 / $885.07