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Maine 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

Facilitymedian $776 · 10th–90th $537–$8910%20%10th90th$776Professionalmedian $575 · 10th–90th $324–$6610%20%10th90th$575$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $501.19 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $794.33 / $891.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $645.65
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $691.83
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $512.86 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $457.09 / $457.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $575.44 / $851.14