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Wisconsin 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 $1,096 · 10th–90th $575–$1,9950%50%10th90th$1,096Professionalmedian $708 · 10th–90th $490–$1,6600%20%10th90th$708$1.0$5.0$20.0$100.0$500.0$2.0K

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
$169.82 / $169.82 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $549.54 / $954.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,819.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,511.89 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,548.82 / $2,089.30
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $891.25 / $1,348.96
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,318.26 / $1,659.59
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $1,071.52 / $5,011.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $562.34 / $1,202.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $416.87
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $1,737.80
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,230.27 / $2,137.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,659.59 / $3,019.95
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,187.76 / $5,011.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,023.29 / $5,495.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $562.34 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $537.03 / $912.01