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California 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

Facilitymedian $562 · 10th–90th $437–$2,5700%20%10th90th$562Professionalmedian $575 · 10th–90th $457–$2,0890%20%40%10th90th$575$1.0$5.0$20.0$100.0$500.0$2.0K$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
$575.44 / $575.44 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $575.44 / $1,949.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $562.34 / $2,398.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $457.09 / $1,513.56
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,548.82 / $2,454.71
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,949.84 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $323.59 / $1,288.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $977.24 / $1,659.59
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,943.28 / $7,943.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $954.99 / $1,348.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $1,023.29
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $338.84 / $977.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $478.63 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $537.03 / $1,148.15