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Knee Orthosis, Single Upright, Custom Fitted

Louisiana 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 $891 · 10th–90th $575$1,9500%20%10th90th$891Professionalmedian $589 · 10th–90th $447$7940%20%40%10th90th$589$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
$616.60
Median
$616.60
Typical High
$616.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$588.84
Typical High
$831.76
BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,621.81
Typical High
$2,238.72
BCBS
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$891.25
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$501.19
Typical High
$724.44