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Knee Orthosis, Single Upright, Custom Fitted

Alaska rates for HCPCS L1843

Knee orthosis (KO), single 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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Rates data updated July 2026.

Facilitymedian $479 · 10th–90th $309$1,0720%20%40%10th90th$479Professionalmedian $617 · 10th–90th $537$1,3180%20%10th90th$617$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$575.44
Typical High
$912.01
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$1,148.15
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$707.95
Typical High
$1,071.52
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,071.52
Typical High
$3,467.37
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,023.29
Typical High
$1,071.52
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,023.29
Typical High
$1,071.52
Providence
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$1,122.02
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$707.95
Typical High
$1,000.00
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$549.54
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$741.31
Typical High
$2,630.27