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

Nebraska 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?

$158

Typical negotiated rate. In Nebraska, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $275 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$158$145 to $234
FacilityA hospital or hospital-owned outpatient department$275$224 to $380

How much rates vary

Facilitymedian $275 · 10th to 90th $186 to $1,148Professionalmedian $158 · 10th to 90th $145 to $251
$100$200$500$1Kfacility $275professional $158

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
$190.55
Median
$190.55
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$158.49
Typical High
$234.42
BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$245.47
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$371.54
Typical High
$851.14
Medica
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$338.84
Typical High
$1,148.15
Medica
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$208.93
Typical High
$323.59
Midlands
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$912.01
Midlands
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
Midlands
Setting
Professional
Modifier
Global
Typical Low
$512.86
Median
$851.14
Typical High
$912.01
United
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$263.03
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$208.93
Typical High
$316.23

Where Nebraska sits

The same service costs 3.6 times more in Kansas 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.

Nebraska· 47th of 51

$158

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.