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Knee Orthosis, Single Upright, Custom Fitted

Montana 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 $1,072 · 10th–90th $708$1,3490%20%10th90th$1,072Professionalmedian $724 · 10th–90th $309$1,3490%10%20%10th90th$724$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Professional
Modifier
Global
Typical Low
$309.03
Median
$562.34
Typical High
$4,570.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,148.15
Typical High
$1,148.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,148.15
Typical High
$1,148.15
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$1,071.52
Typical High
$2,089.30
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,071.52
Typical High
$2,089.30
Providence
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,023.29
Typical High
$1,318.26
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$870.96
Typical High
$1,148.15
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$549.54
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$478.63
Typical High
$741.31