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Mississippi 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
$476.83 / $476.83 / $759.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.55 / $543.88 / $759.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.27 / $681.27 / $981.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$803.76 / $803.76 / $803.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$803.76 / $803.76 / $803.76
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 / $647.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.26 / $542.44 / $858.86