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Knee Orthosis, Single Upright, Off-the-Shelf

South Dakota 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.

How much does Knee Orthosis, Single Upright, Off-the-Shelf cost?

$692

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $692 for this service. The price depends on where it is billed: about $692 from a physician practice, and about $794 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$692$617 to $794
FacilityA hospital or hospital-owned outpatient department$794$631 to $1,047

How much rates vary

Facilitymedian $794 · 10th to 90th $562 to $1,698Professionalmedian $692 · 10th to 90th $479 to $933
$500$1K$2Kfacility $794professional $692

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$794.33
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$616.60
Typical High
$794.33
Avera
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,000.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$1,000.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$758.58
Typical High
$933.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$891.25
Typical High
$1,698.24
Medica
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$724.44
Typical High
$4,466.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,000.00
Typical High
$1,000.00
Midlands
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Midlands
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$1,949.84
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$645.65
Median
$724.44
Typical High
$851.14
United
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$562.34
Typical High
$794.33
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$660.69
Typical High
$870.96
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25

Where South Dakota sits

The same service costs 3.2 times more in Kansas than in Washington, DC. 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.

South Dakota· 6th of 51

$692

KS $1,000DC $309

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.