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Knee Orthosis, Single Upright, Off-the-Shelf

West Virginia 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 October 2026.

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

$525

Typical negotiated rate. In West Virginia, October 2026.

Insurers have agreed to pay about $525 for this service. The price depends on where it is billed: about $525 from a physician practice, and about $631 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$525$468 to $794
FacilityA hospital or hospital-owned outpatient department$631$631 to $676

How much rates vary

Facilitymedian $631 · 10th to 90th $631 to $813Professionalmedian $525 · 10th to 90th $447 to $1,259
$500$1K$2Kfacility $631professional $525

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$446.68
Typical High
$446.68
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$44.67
Median
$44.67
Typical High
$44.67
CareSource
Setting
Facility
Modifier
None
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
CareSource
Setting
Professional
Modifier
None
Typical Low
$501.19
Median
$501.19
Typical High
$851.14
Cigna
Setting
Facility
Modifier
None
Typical Low
$630.96
Median
$630.96
Typical High
$1,000.00
Cigna
Setting
Professional
Modifier
None
Typical Low
$467.74
Median
$467.74
Typical High
$3,311.31
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$616.60
Median
$645.65
Typical High
$645.65
United
Setting
Facility
Modifier
None
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
United
Setting
Professional
Modifier
None
Typical Low
$478.63
Median
$676.08
Typical High
$1,258.93

Where West Virginia sits

The same service costs 2.2 times more in Kansas than in Utah. 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.

West Virginia· 43rd of 51

$525

KS $1,000UT $457

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.