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New Jersey 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

Facilitymedian $363 · 10th–90th $363–$1,0720%50%90th$363Professionalmedian $537 · 10th–90th $407–$1,0470%10%10th90th$537$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $512.86 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,000.00 / $1,445.44
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $478.63 / $1,122.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $562.34 / $1,023.29