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Oklahoma 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
$358.49 / $358.49 / $358.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.21 / $358.49 / $615.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.87 / $663.87 / $663.87
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 / $636.97 / $712.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.49 / $425.96 / $3,153.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $519.57 / $952.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.20 / $500.17 / $769.49