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Knee Orthosis, Single Upright, Custom Fitted

Wyoming 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 $537 · 10th–90th $479$1,0720%20%10th90th$537Professionalmedian $617 · 10th–90th $417$1,0720%20%10th90th$617$500.0$1.0K

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
$416.87
Median
$616.60
Typical High
$954.99
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
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
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$478.63
Typical High
$741.31