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Knee Orthosis, Single Upright, Custom Fitted

Iowa 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 $832 · 10th–90th $490$2,6920%20%10th90th$832Professionalmedian $692 · 10th–90th $479$1,4450%20%10th90th$692$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
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$758.58
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$676.08
Typical High
$1,023.29
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$1,202.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,258.93
Typical High
$1,548.82
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,071.52
Typical High
$1,148.15
Medica
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,288.25
Typical High
$5,011.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$660.69
Typical High
$1,819.70
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,258.93
Typical High
$1,513.56
Midlands
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,819.70
Typical High
$1,819.70
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,445.44
Typical High
$2,344.23
United
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$1,096.48
Typical High
$2,089.30
United
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$537.03
Typical High
$1,071.52
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$1,071.52
Typical High
$1,071.52