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Knee Orthosis, Inflatable Air Chambers, Custom Fitted

Nebraska 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 July 2026.

Facilitymedian $708 · 10th–90th $309$3,2360%20%40%10th90th$708Professionalmedian $324 · 10th–90th $263$5750%20%40%10th90th$324$200.0$500.0$1.0K$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
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$436.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$323.59
Typical High
$436.52
BCBS
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$660.69
Typical High
$676.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$794.33
Typical High
$1,445.44
Medica
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$758.58
Typical High
$3,235.94
Medica
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$346.74
Typical High
$691.83
Midlands
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$1,862.09
Midlands
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
Midlands
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,737.80
Typical High
$1,862.09
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$707.95
Median
$912.01
Typical High
$1,513.56
United
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$707.95
Typical High
$707.95
United
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$346.74
Typical High
$537.03