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

Illinois 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 July 2026.

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

$174

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $174 for this service. The price depends on where it is billed: about $170 from a physician practice, and about $186 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 6 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$170$141 to $229
FacilityA hospital or hospital-owned outpatient department$186$141 to $309

How much rates vary

Facilitymedian $186 · 10th to 90th $141 to $933Professionalmedian $170 · 10th to 90th $141 to $316
$1.0$10.0$100.0$1.0Kfacility $186professional $170

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
$141.25
Median
$141.25
Typical High
$229.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$144.54
Typical High
$229.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$371.54
Typical High
$2,691.53
BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$173.78
Typical High
$173.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$295.12
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$389.05
Typical High
$512.86
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Molina
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$186.21
Typical High
$309.03
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$208.93
Typical High
$323.59

Where Illinois sits

The same service costs 3.6 times more in Kansas than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Illinois $174 · 38th of 51
KS $417DC $115

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.