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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

South Dakota rates for HCPCS L1840

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

Rates data updated July 2026.

How much does Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated cost?

$977

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $977 for this service. The price depends on where it is billed: about $977 from a physician practice, and about $1,023 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$977$708 to $1,318
FacilityA hospital or hospital-owned outpatient department$1,023$955 to $1,202

How much rates vary

Facilitymedian $1,023 · 10th to 90th $724 to $1,413Professionalmedian $977 · 10th to 90th $661 to $1,660
$500.0$1.0K$2.0K$5.0Kfacility $1,023professional $977

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. 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
Global
Typical Low
$758.58
Median
$758.58
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$707.95
Typical High
$1,047.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$1,202.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,659.59
Medica
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$1,047.13
Typical High
$1,949.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$741.31
Typical High
$6,606.93
Midlands
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,174.90
Typical High
$1,174.90
Midlands
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$1,202.26
Typical High
$1,202.26
Midlands
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$1,862.09
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$1,047.13
Typical High
$1,380.38
United
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$602.56
Typical High
$870.96
United
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$794.33
Typical High
$1,318.26
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52

Where South Dakota sits

The same service costs 3.4 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $977 · 6th of 51
HI $1,622DC $479

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.