go back

Maine 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 $1,230 · 10th–90th $708–$1,3490%20%10th90th$1,230Professionalmedian $617 · 10th–90th $457–$1,3800%10%10th90th$617$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
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $588.84 / $1,445.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,258.93 / $1,412.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,096.48
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $616.60 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $316.23 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $912.01 / $933.25