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Knee Orthosis, Single Upright, Custom Fitted

Oklahoma 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 $537 · 10th–90th $490$1,3180%20%10th90th$537Professionalmedian $575 · 10th–90th $437$9550%20%10th90th$575$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
Facility
Modifier
Global
Typical Low
$489.78
Median
$512.86
Typical High
$512.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$512.86
Typical High
$575.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$1,174.90
Medica
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$691.83
Typical High
$5,011.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$524.81
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$891.25
Typical High
$1,122.02
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$478.63
Typical High
$691.83