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Vermont 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 $631 · 10th–90th $479–$7080%20%40%10th90th$631Professionalmedian $550 · 10th–90th $447–$8320%20%40%10th90th$550$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
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $512.86 / $676.08
BCBS
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 / $707.95
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $831.76 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $602.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $812.83 / $1,584.89