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Kentucky 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
$413.99 / $429.32 / $513.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.66 / $429.32 / $610.66
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.09 / $634.26 / $634.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424.59 / $682.08 / $716.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$542.44 / $542.44 / $733.69
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.56 / $920.81 / $1,125.43
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.77 / $818.50 / $1,125.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$621.29 / $647.80 / $794.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.90 / $472.90 / $3,096.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $745.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.16 / $542.44 / $768.45