go back

Wisconsin 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 $646 · 10th–90th $617–$1,1750%50%10th90th$646Professionalmedian $603 · 10th–90th $331–$1,1750%10%10th90th$603$1.0$5.0$20.0$100.0$500.0$2.0K

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
$371.54 / $371.54 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $426.58 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $1,047.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $2,290.87 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $954.99 / $1,202.26
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $616.60 / $831.76
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $676.08 / $912.01
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $630.96 / $3,019.95
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $549.54 / $1,148.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $524.81
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $954.99 / $1,548.82
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,071.52 / $1,737.80
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,258.93 / $3,019.95
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $954.99 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $524.81 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $776.25 / $1,548.82