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Knee Orthosis, Single Upright, Custom Fitted

Idaho 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 $1,000 · 10th–90th $525$1,3180%20%40%10th90th$1,000Professionalmedian $708 · 10th–90th $437$1,1750%10%20%10th90th$708$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
Professional
Modifier
Global
Typical Low
$416.87
Median
$575.44
Typical High
$933.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$1,000.00
Typical High
$1,698.24
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,174.90
Typical High
$1,174.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$707.95
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$707.95
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$977.24
Typical High
$1,174.90
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,023.29
Typical High
$1,071.52
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$912.01
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,023.29
Typical High
$1,023.29
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,174.90
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,096.48
Typical High
$1,621.81
Select Health
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$1,023.29
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$0.78
Median
$549.54
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$478.63
Typical High
$691.83