go back

Utah 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 $479 · 10th–90th $309–$1,0960%20%40%10th90th$479Professionalmedian $708 · 10th–90th $309–$4,5710%10%10th90th$708$50.0$100.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $616.60 / $4,570.88
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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $794.33 / $1,047.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,096.48 / $1,096.48
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $776.25 / $1,174.90
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,096.48 / $1,122.02
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,122.02 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $478.63 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $478.63 / $812.83