go back

New York 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 $661 · 10th–90th $398–$1,8200%20%10th90th$661Professionalmedian $537 · 10th–90th $447–$1,4450%20%10th90th$537$1.0$10.0$100.0$1.0K$10.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $660.69 / $1,202.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $524.81 / $891.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $2,137.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $1,621.81
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $870.96 / $870.96
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $1,258.93
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,778.28 / $4,168.69
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,071.52 / $2,041.74
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $676.08
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $645.65 / $676.08
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,023.29 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $562.34 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $691.83 / $1,778.28
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $630.96 / $676.08
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $645.65 / $676.08