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Maryland 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
Professional
Modifier
Low / Median / High Price
$305.47 / $429.96 / $645.64
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$567.09 / $567.09 / $567.09
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.45 / $617.78 / $926.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$403.53 / $546.86 / $870.75
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $547.82 / $780.28