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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.

How much does Knee Orthosis, Single Upright, Custom Fitted cost?

$646

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $646 for this service. The price depends on where it is billed: about $646 from a physician practice, and about $1,096 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$646$501 to $933
FacilityA hospital or hospital-owned outpatient department$1,096$708 to $1,259

How much rates vary

Facilitymedian $1,096 · 10th to 90th $603 to $1,349Professionalmedian $646 · 10th to 90th $447 to $933
$500$1K$2Kfacility $1,096professional $646

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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

Where Maine sits

The same service costs 2.5 times more in Kansas than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 17th of 51

$646

KS $1,096DC $437

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.