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Knee Orthosis, Single Upright, Off-the-Shelf

Wisconsin 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 $676 · 10th–90th $631$1,2300%50%10th90th$676Professionalmedian $631 · 10th–90th $389$1,1750%20%40%10th90th$631$1.0$5.0$20.0$100.0$500.0$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
$389.05
Median
$389.05
Typical High
$389.05
Aetna
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$398.11
Typical High
$891.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$1,122.02
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$741.31
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$2,454.71
Typical High
$3,388.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$1,000.00
Typical High
$1,258.93
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$645.65
Typical High
$891.25
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$724.44
Typical High
$977.24
Medica
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$660.69
Typical High
$3,162.28
Medica
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$575.44
Typical High
$1,258.93
Molina
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$70.79
Typical High
$616.60
Network Health
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$1,000.00
Typical High
$1,621.81
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$645.65
Typical High
$891.25
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$588.84
Typical High
$660.69
Quartz
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,122.02
Typical High
$1,737.80
Quartz
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$1,380.38
Typical High
$3,235.94
Quartz
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$1,174.90
Typical High
$4,466.84
United
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$549.54
Typical High
$776.25
United
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$537.03
Typical High
$870.96