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Ohio 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 $708 · 10th–90th $479–$1,1480%20%40%10th90th$708Professionalmedian $525 · 10th–90th $347–$1,0470%10%20%10th90th$525$1.0$5.0$20.0$100.0$500.0$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $588.84 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $446.68 / $707.95
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $691.83 / $691.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $707.95 / $1,445.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $851.14 / $1,445.44
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $602.56 / $851.14
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $645.65 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $707.95
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $707.95
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $691.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $794.33 / $1,148.15
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $2,137.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $537.03 / $954.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $512.86 / $776.25