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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Washington, DC rates for HCPCS L1840

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

Rates data updated October 2026.

How much does Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated cost?

$631

Typical negotiated rate. In Washington, DC, October 2026.

Insurers have agreed to pay about $631 for this service. Most negotiated rates run $513 to $776.

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.

How much rates vary

Facilitymedian $479 · 10th to 90th $479 to $776Professionalmedian $631 · 10th to 90th $479 to $1,122
$500$1K$2Kfacility $479professional $631

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
Facility
Modifier
None
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
Aetna
Setting
Professional
Modifier
None
Typical Low
$478.63
Median
$478.63
Typical High
$691.83
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$239.88
Median
$239.88
Typical High
$346.74
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$95.50
Median
$95.50
Typical High
$138.04
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$70.79
Median
$70.79
Typical High
$104.71
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$47.86
Median
$47.86
Typical High
$69.18
CareFirst
Setting
Professional
Modifier
None
Typical Low
$630.96
Median
$630.96
Typical High
$812.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$741.31
Typical High
$776.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$537.03
Median
$537.03
Typical High
$741.31
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$776.25
Median
$1,000.00
Typical High
$2,290.87
United
Setting
Professional
Modifier
None
Typical Low
$389.05
Median
$630.96
Typical High
$1,258.93

Where Washington, DC sits

The same service costs 3.0 times more in Hawaii than in Vermont. 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.

Washington, DC· 38th of 51

$631

HI $1,622VT $537

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.