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Illinois 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 $1,230 · 10th–90th $550–$5,6230%20%10th90th$1,230Professionalmedian $589 · 10th–90th $479–$1,0960%20%40%10th90th$589$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
$549.54 / $549.54 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $562.34 / $1,096.48
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $912.01
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,089.30 / $7,413.10
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $1,258.93
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,148.15 / $1,659.59
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $891.25 / $1,584.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $537.03 / $831.76