Knee Orthosis, Inflatable Air Chambers, Custom Fitted
Arizona rates for HCPCS L1847
Knee orthosis (KO), double upright with adjustable joint, with inflatable air support chamber(s), 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 October 2026.
How much does Knee Orthosis, Inflatable Air Chambers, Custom Fitted cost?
$309
Typical negotiated rate. In Arizona, October 2026.
Insurers have agreed to pay about $309 for this service. The price depends on where it is billed: about $309 from a physician practice, and about $676 from a hospital or other facility.
These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.
Prices by location type
Billed by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$309
$282 to $550
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$676
$389 to $1,148
How much rates vary
Facilitymedian $676 · 10th to 90th $191 to $3,236Professionalmedian $309 · 10th to 90th $269 to $3,467
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
Professional
None
$269.15
$269.15
$269.15
BCBS Arizona
Setting
Facility
Modifier
None
Typical Low
$165.96
Median
$741.31
Typical High
$1,148.15
Facility
None
$165.96
$741.31
$1,148.15
BCBS Arizona
Setting
Professional
Modifier
None
Typical Low
$478.63
Median
$549.54
Typical High
$1,000.00
Professional
None
$478.63
$549.54
$1,000.00
Cigna
Setting
Facility
Modifier
None
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Facility
None
$389.05
$389.05
$389.05
Cigna
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$281.84
Typical High
$389.05
Professional
None
$281.84
$281.84
$389.05
Medica
Setting
Facility
Modifier
None
Typical Low
$288.40
Median
$676.08
Typical High
$3,235.94
Facility
None
$288.40
$676.08
$3,235.94
Medica
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$371.54
Typical High
$3,467.37
Professional
None
$288.40
$371.54
$3,467.37
United
Setting
Professional
Modifier
None
Typical Low
$281.84
Median
$309.03
Typical High
$467.74
Professional
None
$281.84
$309.03
$467.74
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Professional
52 · Reduced service
$134.90
$134.90
$134.90
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
Professional
53 · Discontinued
$53.70
$53.70
$53.70
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$40.74
Median
$40.74
Typical High
$40.74
Professional
55 · Aftercare only
$40.74
$40.74
$40.74
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$26.92
Median
$26.92
Typical High
$26.92
Professional
56 · Pre-op care only
$26.92
$26.92
$26.92
Where Arizona sits
The same service costs 2.5 times more in Iowa than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.