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Ohio 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 $1,175 · 10th–90th $575–$1,9500%20%40%10th90th$1,175Professionalmedian $575 · 10th–90th $447–$9770%20%40%10th90th$575$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,023.29 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $575.44 / $870.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,174.90 / $2,344.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $630.96 / $1,445.44
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $912.01
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $933.25 / $1,318.26
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $977.24 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $398.11 / $575.44
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,318.26
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,230.27 / $2,290.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $794.33 / $1,122.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $512.86 / $741.31