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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

Facilitymedian $1,318 · 10th–90th $457–$1,9050%20%10th90th$1,318Professionalmedian $646 · 10th–90th $457–$1,0720%20%10th90th$646$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $562.34 / $1,071.52
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $5,128.61
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $812.83 / $1,174.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,380.38 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $707.95 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $741.31
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,380.38
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,023.29 / $5,128.61
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $812.83 / $1,174.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $562.34 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $724.44 / $933.25