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Pennsylvania 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 $955 · 10th–90th $331–$1,2880%20%10th90th$955Professionalmedian $468 · 10th–90th $339–$7590%20%10th90th$468$1.0$10.0$100.0$1.0K$10.0K

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
$331.13 / $1,288.25 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $446.68 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $691.83
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $630.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
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 / $676.08
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $870.96 / $1,258.93
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $467.74 / $660.69
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $660.69 / $707.95
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $446.68 / $707.95
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $416.87 / $1,584.89
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $933.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $954.99 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $524.81 / $912.01