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TLSO, Flexible, Sacrococcygeal to T-9, Off-the-Shelf

Florida rates for HCPCS L0455

Thoracic-lumbar-sacral orthosis (TLSO), flexible, provides trunk support, extends from sacrococcygeal junction to above T-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf

Rates data updated October 2026.

How much does TLSO, Flexible, Sacrococcygeal to T-9, Off-the-Shelf cost?

$204

Typical negotiated rate. In Florida, October 2026.

Insurers have agreed to pay about $204 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $501 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$204$186 to $229
FacilityA hospital or hospital-owned outpatient department$501$275 to $646

How much rates vary

Facilitymedian $501 · 10th to 90th $275 to $646Professionalmedian $204 · 10th to 90th $174 to $269
$100$200$500facility $501professional $204

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$229.09
Aetna
Setting
Professional
Modifier
None
Typical Low
$151.36
Median
$177.83
Typical High
$229.09
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$75.86
Median
$89.13
Typical High
$114.82
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$30.20
Median
$35.48
Typical High
$45.71
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$22.91
Median
$26.92
Typical High
$34.67
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$15.14
Median
$17.78
Typical High
$22.91
AvMed
Setting
Facility
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$269.15
AvMed
Setting
Professional
Modifier
None
Typical Low
$213.80
Median
$269.15
Typical High
$281.84
Cigna
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$204.17
Typical High
$275.42
Florida Blue
Setting
Facility
Modifier
None
Typical Low
$501.19
Median
$501.19
Typical High
$645.65
Florida Blue
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$269.15
Typical High
$331.13
Molina
Setting
Professional
Modifier
None
Typical Low
$169.82
Median
$186.21
Typical High
$208.93
United
Setting
Facility
Modifier
None
Typical Low
$416.87
Median
$416.87
Typical High
$416.87
United
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$208.93
Typical High
$263.03
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$269.15

Where Florida sits

The same service costs 2.6 times more in Hawaii than in Utah. 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.

Florida· 36th of 51

$204

HI $417UT $162

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.