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Connecticut 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
$476.87 / $476.87 / $476.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.80 / $476.87 / $586.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.92 / $660.54 / $755.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.37 / $653.37 / $653.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$621.29 / $647.80 / $647.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.90 / $472.90 / $472.90
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$429.35 / $429.35 / $429.35
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.56 / $429.35 / $568.36
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.24 / $478.24 / $478.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.85 / $489.49 / $722.87