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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Hawaii rates for HCPCS L1840

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

Rates data updated July 2026.

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

$1,622

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $1,622 for this service. Most negotiated rates run $741 to $1,622.

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 $676 · 10th to 90th $513 to $1,259Professionalmedian $1,622 · 10th to 90th $398 to $1,698
$500$1K$2Kfacility $676professional $1,622

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. 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
Global
Typical Low
$398.11
Median
$398.11
Typical High
$588.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$1,258.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,479.11
Typical High
$1,995.26
HMSA
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,698.24
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,621.81
Typical High
$2,238.72
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$645.65
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$870.96
Typical High
$1,949.84

Where Hawaii sits

The same service costs 3.4 times more in Hawaii than in Washington, DC. 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.

Hawaii· 1st of 51

$1,622

HI $1,622DC $479

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.