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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Massachusetts rates for HCPCS L1840

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

Rates data updated July 2026.

Facilitymedian $1,380 · 10th–90th $479$2,1880%20%10th90th$1,380Professionalmedian $955 · 10th–90th $479$1,4450%20%10th90th$955$1.0$10.0$100.0$1.0K$10.0K

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
$478.63
Median
$478.63
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$537.03
Typical High
$1,698.24
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,122.02
Typical High
$6,760.83
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$851.14
Typical High
$1,348.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,445.44
Typical High
$1,905.46
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$741.31
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$758.58
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,445.44
Health New England
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$724.44
Typical High
$724.44
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,122.02
Typical High
$6,760.83
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$851.14
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$660.69
Typical High
$1,412.54
United
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$912.01
Typical High
$1,047.13