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Knee Orthosis, Single Upright, Off-the-Shelf

Utah 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 $479 · 10th–90th $427$6170%20%40%10th90th$479Professionalmedian $617 · 10th–90th $339$2,5120%10%20%10th90th$617$50.0$100.0$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
$426.58
Median
$426.58
Typical High
$426.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$616.60
Typical High
$2,511.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$467.74
Typical High
$630.96
Molina
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$436.52
Typical High
$562.34
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$602.56
Typical High
$691.83
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$676.08
Select Health
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Select Health
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$616.60
Typical High
$912.01
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$549.54
Median
$616.60
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$478.63
Typical High
$602.56
United
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$457.09
Typical High
$660.69