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TLSO, Triplanar Control, Two Rigid Shells, Custom Fitted

Oregon rates for HCPCS L0460

Thoracic-lumbar-sacral orthosis (TLSO), triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Rates data updated July 2026.

Facilitymedian $1,148 · 10th–90th $891$1,2020%50%10th90th$1,148Professionalmedian $871 · 10th–90th $513$1,3180%10%20%10th90th$871$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$645.65
Typical High
$831.76
Cigna
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$954.99
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$2,398.83
Typical High
$2,884.03
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$912.01
Typical High
$1,202.26
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$933.25
Typical High
$1,288.25
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,148.15
Typical High
$1,202.26
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,174.90
Typical High
$1,288.25
Providence
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$977.24
Typical High
$1,412.54
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$1,023.29
Typical High
$1,230.27
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,230.27
Typical High
$4,677.35
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,318.26
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$0.85
Median
$537.03
Typical High
$1,778.28
United
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$537.03
Typical High
$1,023.29