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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 July 2026.

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

$617

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $617 for this service. The price depends on where it is billed: about $617 from a physician practice, and about $1,318 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 8 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$617$575 to $1,023
FacilityA hospital or hospital-owned outpatient department$1,318$617 to $2,884

How much rates vary

Facilitymedian $1,318 · 10th to 90th $550 to $4,365Professionalmedian $617 · 10th to 90th $513 to $1,072
$10$100$1K$10Kfacility $1,318professional $617

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$575.44
Typical High
$724.44
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$3,235.94
Typical High
$6,165.95
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,071.52
Typical High
$1,148.15
CareSource
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$707.95
Typical High
$1,202.26
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$2,041.74
Typical High
$2,290.87
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$870.96
Typical High
$1,318.26
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$891.25
Typical High
$1,202.26
United
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$891.25
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$512.86
Typical High
$776.25

Where Michigan 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.

Michigan· 23rd of 51

$617

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.