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Rhode Island 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
Professional
Modifier
Low / Median / High Price
$418.55 / $447.09 / $617.58
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,315.03 / $1,461.14 / $2,030.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.36 / $586.30 / $718.55
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 / $472.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.85 / $489.49 / $815.81