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Knee Orthosis, Single Upright, Custom Fitted

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

Rates data updated July 2026.

Facilitymedian $1,072 · 10th–90th $525$1,3180%20%40%10th90th$1,072Professionalmedian $525 · 10th–90th $437$9550%20%40%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
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$524.81
Typical High
$524.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$524.81
Typical High
$616.60
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,148.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$933.25
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$741.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$707.95
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$660.69
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,071.52
Typical High
$1,513.56
Medcost
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$707.95
Typical High
$1,047.13
Medcost
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$691.83
Typical High
$1,230.27
Medcost
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$707.95
Typical High
$1,348.96
Sentara
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$891.25
Typical High
$2,290.87
Sentara
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$891.25
Typical High
$2,290.87
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$524.81
Typical High
$851.14