go back

North Dakota 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
$691.92 / $691.92 / $691.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.50 / $586.95 / $691.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.50 / $680.45 / $697.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.63 / $720.76 / $906.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.55 / $623.34 / $3,006.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.88 / $546.50 / $770.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.32 / $513.58 / $770.37