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West Virginia 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
$443.44 / $443.44 / $443.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.39 / $512.85 / $615.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$464.74 / $965.22 / $1,251.22
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.74 / $500.49 / $857.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$636.97 / $712.60 / $832.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.99 / $636.97 / $3,248.20
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.96 / $732.96 / $732.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.99 / $546.47 / $924.80