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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Montana 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?

$1,096

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $1,096 for this service. The price depends on where it is billed: about $1,047 from a physician practice, and about $1,096 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,047$513 to $1,096
FacilityA hospital or hospital-owned outpatient department$1,096$1,047 to $60,256

How much rates vary

Facilitymedian $1,096 · 10th to 90th $776 to $61,660Professionalmedian $1,047 · 10th to 90th $79 to $1,202
$100$500$2K$10K$50Kfacility $1,096professional $1,047

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$331.13
Median
$588.84
Typical High
$1,071.52
Cigna
Setting
Facility
Modifier
None
Typical Low
$776.25
Median
$1,096.48
Typical High
$1,096.48
Cigna
Setting
Professional
Modifier
None
Typical Low
$891.25
Median
$1,096.48
Typical High
$1,096.48
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$794.33
Median
$1,318.26
Typical High
$61,659.50
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$1,047.13
Median
$1,230.27
Typical High
$64,565.42
Providence
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$1,096.48
Typical High
$1,096.48
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$812.83
Typical High
$1,096.48
United
Setting
Professional
Modifier
None
Typical Low
$478.63
Median
$512.86
Typical High
$870.96

Where Montana 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.

Montana· 5th of 51

$1,096

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.