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Texas 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 $891 · 10th–90th $490–$2,1880%10%20%10th90th$891Professionalmedian $513 · 10th–90th $457–$7760%50%10th90th$513$1.0$5.0$20.0$100.0$500.0$2.0K$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
$489.78 / $501.19 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $512.86 / $851.14
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $1,096.48
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,943.28 / $7,943.28
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $851.14 / $1,412.54
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $524.81 / $1,071.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $645.65
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $4,073.80 / $4,073.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $812.83 / $1,445.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $676.08 / $1,122.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $575.44 / $691.83
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,096.48 / $1,096.48