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Georgia 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
$417.80 / $417.80 / $1,071.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.09 / $527.75 / $662.16
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.08 / $908.36 / $1,433.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$682.08 / $954.91 / $2,503.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.70 / $914.00 / $1,532.38
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$531.12 / $682.08 / $1,362.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.77 / $579.77 / $579.77
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 / $857.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.38 / $682.08 / $1,801.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$624.85 / $874.12 / $1,261.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.38 / $566.05 / $904.06