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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

Utah 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?

$617

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $617 for this service. The price depends on where it is billed: about $617 from a physician practice, and about $513 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$617$468 to $1,047
FacilityA hospital or hospital-owned outpatient department$513$331 to $1,047

How much rates vary

Facilitymedian $513 · 10th to 90th $331 to $1,047Professionalmedian $617 · 10th to 90th $331 to $6,026
$500$1K$2K$5Kfacility $513professional $617

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$562.34
Typical High
$6,025.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$741.31
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$758.58
Typical High
$977.24
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,047.13
Typical High
$1,047.13
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$575.44
Median
$741.31
Typical High
$1,348.96
Select Health
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,047.13
Select Health
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$1,047.13
Typical High
$1,230.27
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,047.13
Typical High
$1,479.11
United
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$645.65
Typical High
$954.99
United
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$512.86
Typical High
$794.33

Where Utah sits

The same service costs 3.4 times more in Hawaii than in Washington, DC. 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.

Utah· 31st of 51

$617

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.