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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$438.73 / $486.28 / $664.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,378.47 / $1,531.63 / $2,183.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.97 / $630.54 / $759.24
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.75 / $526.41 / $877.36