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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Rhode Island rates for HCPCS L1840

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

Rates data updated July 2026.

Facilitymedian $1,820 · 10th–90th $631$2,5700%10%10th90th$1,820Professionalmedian $617 · 10th–90th $479$7410%20%10th90th$617$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$537.03
Typical High
$645.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$2,187.76
Typical High
$2,570.40
BCBS
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$724.44
Typical High
$1,047.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
United
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$630.96
Typical High
$1,412.54
United
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$602.56
Typical High
$912.01