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Knee Orthosis, Single Upright, Custom Fitted

Indiana 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 $537$1,3490%50%10th90th$1,096Professionalmedian $550 · 10th–90th $457$8910%50%10th90th$550$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
$537.03
Median
$537.03
Typical High
$537.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$537.03
Typical High
$891.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$831.76
Typical High
$831.76
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$1,096.48
Typical High
$1,380.38
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$588.84
Typical High
$1,047.13
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,412.54
Typical High
$1,621.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$1,513.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$954.99
United
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$602.56
Typical High
$1,096.48
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$537.03
Typical High
$758.58