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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 October 2026.

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

$513

Typical negotiated rate. In Maine, October 2026.

Insurers have agreed to pay about $513 for this service. The price depends on where it is billed: about $513 from a physician practice, and about $1,318 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$513$457 to $646
FacilityA hospital or hospital-owned outpatient department$1,318$1,047 to $2,291

How much rates vary

Facilitymedian $1,318 · 10th to 90th $776 to $2,512Professionalmedian $513 · 10th to 90th $447 to $933
$500$1K$2Kfacility $1,318professional $513

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$575.44
Median
$645.65
Typical High
$645.65
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$1,047.13
Median
$1,348.96
Typical High
$2,511.89
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$446.68
Median
$457.09
Typical High
$489.78
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$45.71
Median
$45.71
Typical High
$50.12
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$199.53
Median
$199.53
Typical High
$218.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$707.95
Typical High
$776.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$512.86
Median
$512.86
Typical High
$707.95
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$416.87
Median
$933.25
Typical High
$1,202.26
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$575.44
Median
$645.65
Typical High
$645.65
United
Setting
Facility
Modifier
None
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
United
Setting
Professional
Modifier
None
Typical Low
$416.87
Median
$524.81
Typical High
$1,445.44

Where Maine sits

The same service costs 2.1 times more in Iowa than in New Hampshire. 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· 48th of 51

$513

IA $1,096NH $513

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.