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Maryland 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 $479 · 10th–90th $302–$7410%10%20%10th90th$479Professionalmedian $550 · 10th–90th $427–$9550%10%10th90th$550$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $537.03 / $954.99
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,071.52 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $467.74 / $741.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $524.81 / $831.76
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $575.44 / $912.01