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Knee Orthosis, Single Upright, Custom Fitted

Nebraska 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 $1,096 · 10th–90th $479$5,0120%20%10th90th$1,096Professionalmedian $501 · 10th–90th $417$8910%20%40%10th90th$501$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
Facility
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$501.19
Typical High
$691.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,047.13
Typical High
$1,047.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$1,202.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$1,258.93
Typical High
$2,238.72
Medica
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$1,174.90
Typical High
$5,011.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$537.03
Typical High
$1,047.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$2,884.03
Midlands
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
Midlands
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$2,691.53
Typical High
$2,884.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,445.44
Typical High
$2,344.23
United
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$891.25
Typical High
$1,122.02
United
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$537.03
Typical High
$851.14