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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Maine 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?

$661

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $661 for this service. The price depends on where it is billed: about $661 from a physician practice, and about $1,148 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$661$617 to $955
FacilityA hospital or hospital-owned outpatient department$1,148$741 to $1,288

How much rates vary

Facilitymedian $1,148 · 10th to 90th $646 to $1,380Professionalmedian $661 · 10th to 90th $513 to $955
$500.0$1.0K$2.0K$5.0Kfacility $1,148professional $661

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
$478.63
Median
$616.60
Typical High
$741.31
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,288.25
Typical High
$1,479.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$812.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$812.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$741.31
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$1,148.15
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$616.60
Typical High
$660.69
United
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$645.65
Typical High
$691.83
United
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$954.99
Typical High
$954.99

Where Maine sits

The same service costs 3.4 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Maine $661 · 23rd of 51
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.