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Washington, DC 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
$305.47 / $305.47 / $305.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.47 / $305.47 / $586.95
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.09 / $567.09 / $567.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.90 / $472.90 / $472.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.56 / $401.56 / $1,219.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.18 / $546.27 / $715.40