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West Virginia 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
$434.45 / $434.45 / $434.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.25 / $437.94 / $586.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.35 / $920.81 / $1,193.64
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.35 / $477.46 / $818.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$621.29 / $647.80 / $794.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.90 / $472.90 / $3,096.90
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.87 / $735.90 / $755.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.25 / $550.27 / $910.45