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Knee Orthosis, Single Upright, Custom Fitted

Michigan 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?

$851

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $851 for this service. The price depends on where it is billed: about $813 from a physician practice, and about $1,660 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$813$617 to $1,072
FacilityA hospital or hospital-owned outpatient department$1,660$708 to $3,162

How much rates vary

Facilitymedian $1,660 · 10th to 90th $708 to $4,677Professionalmedian $813 · 10th to 90th $513 to $1,096
$500$1K$2K$5K$10Kfacility $1,660professional $813

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
Facility
Modifier
None
Typical Low
$630.96
Median
$1,071.52
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
None
Typical Low
$588.84
Median
$630.96
Typical High
$1,071.52
Ambetter
Setting
Professional
Modifier
None
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$1,318.26
Median
$3,162.28
Typical High
$6,025.60
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$1,023.29
Median
$1,071.52
Typical High
$1,071.52
CareSource
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Professional
Modifier
None
Typical Low
$512.86
Median
$707.95
Typical High
$1,202.26
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$616.60
Median
$2,089.30
Typical High
$2,290.87
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$616.60
Median
$812.83
Typical High
$1,096.48
Priority Health
Setting
Facility
Modifier
None
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Priority Health
Setting
Professional
Modifier
None
Typical Low
$512.86
Median
$707.95
Typical High
$1,071.52
United
Setting
Facility
Modifier
None
Typical Low
$316.23
Median
$1,122.02
Typical High
$1,318.26
United
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$512.86
Typical High
$741.31
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
BCBS Michigan
Setting
Professional
Modifier
RR · Rental
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52

Where Michigan 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.

Michigan· 15th of 51

$851

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.