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Knee Orthosis, Single Upright, Off-the-Shelf

New Hampshire 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 $741 · 10th–90th $631$8710%50%10th90th$741Professionalmedian $603 · 10th–90th $468$7590%20%10th90th$603$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
$630.96
Median
$630.96
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$630.96
Typical High
$758.58
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$758.58
Typical High
$870.96
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$707.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$707.95
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$1,122.02
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$501.19
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$602.56
Typical High
$851.14
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$851.14