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Knee Orthosis, Single Upright, Custom Fitted

Hawaii 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 $603 · 10th–90th $479$8320%20%10th90th$603Professionalmedian $1,072 · 10th–90th $363$1,1220%20%40%10th90th$1,072$500.0$1.0K$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$549.54
Typical High
$575.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$977.24
Typical High
$1,318.26
HMSA
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,122.02
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,071.52
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$741.31
Typical High
$1,318.26