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Knee Orthosis, Single Upright, Custom Fitted

Washington 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 $1,047 · 10th–90th $708$2,3440%20%10th90th$1,047Professionalmedian $832 · 10th–90th $513$1,6600%10%10th90th$832$10.0$50.0$200.0$1.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$1,698.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$707.95
Typical High
$1,445.44
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,023.29
Typical High
$1,047.13
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$1,174.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$512.86
Typical High
$707.95
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$1,445.44
Typical High
$3,019.95
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,230.27
Typical High
$2,238.72
Molina
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$812.83
Typical High
$891.25
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$1,023.29
Typical High
$1,071.52
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,148.15
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,548.82
Typical High
$2,089.30
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,023.29
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,047.13
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$1,584.89
Typical High
$1,584.89
United
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$524.81
Typical High
$933.25
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$912.01
Typical High
$1,621.81