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Utah 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 $490 · 10th–90th $427–$6310%20%40%10th90th$490Professionalmedian $617 · 10th–90th $331–$9330%20%10th90th$617$50.0$100.0$200.0$500.0$1.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $616.60 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $630.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $436.52 / $562.34
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $602.56 / $691.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $676.08
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $616.60 / $933.25
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $616.60 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $478.63 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $478.63 / $660.69