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Knee Orthosis, Single Upright, Custom Fitted

Kentucky 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.

How much does Knee Orthosis, Single Upright, Custom Fitted cost?

$562

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $562 for this service. The price depends on where it is billed: about $562 from a physician practice, and about $575 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$562$525 to $575
FacilityA hospital or hospital-owned outpatient department$575$562 to $1,175

How much rates vary

Facilitymedian $575 · 10th to 90th $407 to $1,514Professionalmedian $562 · 10th to 90th $479 to $871
$500$1K$2Kfacility $575professional $562

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$575.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$575.44
Typical High
$870.96
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,096.48
Typical High
$1,174.90
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$562.34
Typical High
$575.44
CareSource
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$1,479.11
Typical High
$1,905.46
CareSource
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,348.96
Typical High
$1,737.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,513.56
Typical High
$1,513.56
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$741.31
Typical High
$5,248.07
Molina
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$724.44
Typical High
$933.25
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$524.81
Typical High
$741.31

Where Kentucky sits

The same service costs 2.5 times more in Kansas than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Kentucky· 37th of 51

$562

KS $1,096DC $437

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.