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Knee Orthosis, Single Upright, Custom Fitted

Massachusetts 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 $1,318 · 10th–90th $457$2,1380%20%10th90th$1,318Professionalmedian $891 · 10th–90th $457$1,3800%20%10th90th$891$1.0$10.0$100.0$1.0K$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
$457.09
Median
$457.09
Typical High
$457.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$537.03
Typical High
$1,445.44
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,023.29
Typical High
$5,128.61
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$812.83
Typical High
$1,288.25
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,380.38
Typical High
$1,819.70
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$707.95
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$741.31
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$1,380.38
Health New England
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,023.29
Typical High
$5,128.61
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$812.83
Typical High
$1,288.25
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$575.44
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$870.96
Typical High
$1,000.00