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Pennsylvania 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 $933 · 10th–90th $41–$1,2590%20%10th90th$933Professionalmedian $468 · 10th–90th $324–$7590%20%10th90th$468$1.0$10.0$100.0$1.0K$10.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $977.24 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $436.52 / $741.31
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $660.69 / $933.25
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $645.65 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $645.65
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $831.76 / $1,202.26
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $446.68 / $630.96
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $588.84 / $794.33
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $870.96 / $954.99
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $977.24
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $436.52 / $691.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $457.09 / $660.69
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $954.99 / $954.99
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $707.95 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $933.25 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $549.54 / $954.99