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Virginia 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 $1,072 · 10th–90th $437–$1,3490%20%40%10th90th$1,072Professionalmedian $525 · 10th–90th $437–$9770%20%10th90th$525$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
$331.13 / $426.58 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $524.81 / $954.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,148.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $933.25
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $707.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,071.52 / $1,513.56
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $707.95 / $1,047.13
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $691.83 / $1,230.27
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $707.95 / $1,348.96
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $2,290.87
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $891.25 / $2,290.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $478.63 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $524.81 / $851.14