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Knee Orthosis, Single Upright, Custom Fitted

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

Rates data updated July 2026.

Facilitymedian $1,096 · 10th–90th $550$5,6230%20%10th90th$1,096Professionalmedian $661 · 10th–90th $501$1,0960%20%40%10th90th$661$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
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$549.54
Typical High
$1,096.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$549.54
Typical High
$1,096.48
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$2,089.30
Typical High
$7,413.10
BCBS
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$831.76
Typical High
$831.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$724.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$1,258.93
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,148.15
Typical High
$1,659.59
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,412.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$870.96
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$891.25
Typical High
$1,096.48
United
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$537.03
Typical High
$1,000.00