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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

New Jersey 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?

$575

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $575 for this service. The price depends on where it is billed: about $575 from a physician practice, and about $741 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$575$479 to $1,202
FacilityA hospital or hospital-owned outpatient department$741$646 to $741

How much rates vary

Facilitymedian $741 · 10th to 90th $646 to $1,202Professionalmedian $575 · 10th to 90th $398 to $1,202
$500$1Kfacility $741professional $575

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$457.09
Aetna
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$512.86
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$199.53
Median
$199.53
Typical High
$251.19
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$79.43
Median
$79.43
Typical High
$102.33
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$58.88
Median
$58.88
Typical High
$75.86
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$39.81
Median
$39.81
Typical High
$51.29
Cigna
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$741.31
Typical High
$1,202.26
Cigna
Setting
Professional
Modifier
None
Typical Low
$537.03
Median
$537.03
Typical High
$741.31
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$776.25
Median
$1,548.82
Typical High
$1,548.82
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
United
Setting
Facility
Modifier
None
Typical Low
$645.65
Median
$691.83
Typical High
$1,202.26
United
Setting
Professional
Modifier
None
Typical Low
$457.09
Median
$616.60
Typical High
$1,148.15

Where New Jersey 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.

New Jersey· 45th of 51

$575

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.