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Minnesota 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
$502.50 / $502.50 / $502.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.55 / $586.95 / $645.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.84 / $782.71 / $1,128.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.54 / $803.40 / $845.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$647.80 / $1,888.05 / $5,243.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.63 / $756.44 / $906.30
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,120.92 / $1,811.50 / $4,129.06
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.63 / $713.63 / $730.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.55 / $615.51 / $3,006.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.26 / $513.75 / $1,013.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.26 / $474.46 / $1,013.50