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Nationwide rates for HCPCS L1852

Knee orthosis (KO), double 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
$323.59 / $501.19 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $501.19 / $776.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $794.33 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $660.69 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $645.65 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $912.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $512.86 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $537.03 / $776.25