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Knee Orthosis, Single Upright, Off-the-Shelf

Hawaii rates for HCPCS L1851

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, off-the-shelf

Rates data updated July 2026.

Facilitymedian $550 · 10th–90th $479$7080%20%10th90th$550Professionalmedian $912 · 10th–90th $398$9550%20%40%10th90th$912$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
$380.19
Median
$616.60
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$831.76
Typical High
$1,122.02
HMSA
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$954.99
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$912.01
Typical High
$1,258.93
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$501.19
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$812.83
Typical High
$1,318.26