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

South Carolina 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?

$178

Typical negotiated rate. In South Carolina, July 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $200 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$178$151 to $282
FacilityA hospital or hospital-owned outpatient department$200$151 to $275

How much rates vary

Facilitymedian $200 · 10th to 90th $151 to $417Professionalmedian $178 · 10th to 90th $138 to $282
$100$200$500facility $200professional $178

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
$151.36
Median
$151.36
Typical High
$151.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$158.49
Typical High
$281.84
BCBS
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$346.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$346.74
Typical High
$436.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$295.12
Medcost
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$213.80
Typical High
$501.19
Medcost
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$117.49
Molina
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$223.87
Typical High
$416.87
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$208.93
Typical High
$295.12

Where South Carolina 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.

South Carolina· 36th of 51

$178

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.