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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Nationwide rates for HCPCS L1840

Knee orthosis (KO), derotation, medial-lateral, anterior cruciate ligament, custom fabricated

Rates data updated July 2026.

Facilitymedian $871 · 10th–90th $490$2,7540%10%20%10th90th$871Professionalmedian $646 · 10th–90th $479$1,2300%20%10th90th$646$1.0$10.0$100.0$1.0K$10.0K$100.0K$1.0M

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
$478.63
Median
$588.84
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$588.84
Typical High
$1,000.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$467.74
Median
$645.65
Typical High
$2,570.40
BCBS
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$660.69
Typical High
$1,380.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$4,265.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$1,659.59
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$691.83
Typical High
$1,412.54
United
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$575.44
Typical High
$1,071.52