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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

North Carolina rates for HCPCS L1840

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

Rates data updated July 2026.

Facilitymedian $1,000 · 10th–90th $490$2,2390%20%10th90th$1,000Professionalmedian $871 · 10th–90th $501$1,0000%20%40%10th90th$871$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
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$1,000.00
Typical High
$1,000.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,659.59
Typical High
$2,238.72
BCBS
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$954.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$741.31
Typical High
$776.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$776.25
Medcost
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$630.96
Typical High
$776.25
Medcost
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$1,000.00
Typical High
$1,698.24
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$776.25
Typical High
$1,148.15
United
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$562.34
Typical High
$794.33
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$5,623.41
Median
$5,623.41
Typical High
$5,623.41
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$6,760.83
Median
$6,760.83
Typical High
$8,709.64