go back

Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Minnesota rates for HCPCS L1840

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

Rates data updated July 2026.

Facilitymedian $1,950 · 10th–90th $977$9,3330%20%10th90th$1,950Professionalmedian $1,122 · 10th–90th $661$1,3180%50%10th90th$1,122$1.0$5.0$20.0$100.0$500.0$2.0K$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
$794.33
Median
$794.33
Typical High
$794.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$457.09
Median
$724.44
Typical High
$794.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,659.59
BCBS
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,122.02
Typical High
$1,122.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$4,265.80
Typical High
$11,748.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,513.56
Typical High
$1,659.59
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$3,311.31
Median
$4,677.35
Typical High
$9,332.54
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,778.28
Medica
Setting
Facility
Modifier
Global
Typical Low
$549.54
Median
$1,122.02
Typical High
$5,495.41
Medica
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$512.86
Typical High
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$8.32
Median
$512.86
Typical High
$1,698.24
United
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$602.56
Typical High
$1,584.89