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Knee Orthosis, Single Upright, Custom Fitted

Vermont 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 $603 · 10th–90th $316$7760%20%40%10th90th$603Professionalmedian $589 · 10th–90th $513$8320%20%40%10th90th$589$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
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$831.76
BCBS
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$851.14
Typical High
$851.14
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$707.95
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$1,023.29
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$478.63
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$741.31
Typical High
$2,137.96