go back

Knee Orthosis, Single Upright, Custom Fitted

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

Rates data updated July 2026.

Facilitymedian $1,096 · 10th–90th $603$1,3490%20%10th90th$1,096Professionalmedian $646 · 10th–90th $447$9330%20%10th90th$646$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
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$575.44
Typical High
$645.65
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,258.93
Typical High
$1,412.54
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$758.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$707.95
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$1,096.48
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$588.84
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$478.63
Typical High
$616.60
United
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$912.01
Typical High
$933.25