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Knee Orthosis, Anterior Cruciate Ligament, Custom Fabricated

West Virginia 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?

$603

Typical negotiated rate. In West Virginia, October 2026.

Insurers have agreed to pay about $603 for this service. The price depends on where it is billed: about $603 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$603$550 to $776
FacilityA hospital or hospital-owned outpatient department$741$741 to $1,202

How much rates vary

Facilitymedian $741 · 10th to 90th $692 to $1,622Professionalmedian $603 · 10th to 90th $537 to $1,288
$500$1K$2K$5Kfacility $741professional $603

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
Professional
Modifier
None
Typical Low
$575.44
Median
$602.56
Typical High
$602.56
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$288.40
Median
$302.00
Typical High
$302.00
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$114.82
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$87.10
Median
$91.20
Typical High
$91.20
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$57.54
Median
$60.26
Typical High
$60.26
CareSource
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$741.31
Typical High
$741.31
CareSource
Setting
Professional
Modifier
None
Typical Low
$794.33
Median
$794.33
Typical High
$1,348.96
Cigna
Setting
Facility
Modifier
None
Typical Low
$741.31
Median
$741.31
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
None
Typical Low
$537.03
Median
$537.03
Typical High
$5,754.40
United
Setting
Facility
Modifier
None
Typical Low
$645.65
Median
$691.83
Typical High
$1,202.26
United
Setting
Professional
Modifier
None
Typical Low
$549.54
Median
$660.69
Typical High
$1,288.25

Where West Virginia 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.

West Virginia· 42nd of 51

$603

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.