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Knee Orthosis, Single Upright, Custom Fitted

Missouri 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 $871 · 10th–90th $562$1,8620%20%10th90th$871Professionalmedian $589 · 10th–90th $479$1,2880%20%40%10th90th$589$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$645.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$588.84
Typical High
$4,570.88
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$831.76
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$3,801.89
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$588.84
Typical High
$1,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$1,096.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$1,047.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$707.95
Medica
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$870.96
Typical High
$5,011.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$537.03
Typical High
$5,495.41
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$870.96
Typical High
$1,096.48
United
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$537.03
Typical High
$933.25