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Illinois rates for HCPCS L1852

Knee Orthosis (Ko) Double Upright Thigh And Calfwith 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
$375.38 / $375.38 / $375.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.42 / $440.42 / $669.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,116.29 / $3,516.72 / $7,670.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.22 / $474.89 / $474.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$621.29 / $647.80 / $881.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.90 / $472.90 / $881.60
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.61 / $1,016.68 / $4,062.97
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.31 / $812.31 / $812.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.68 / $503.52 / $891.59