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TLSO, Sagittal-Coronal Control, Rigid Frame, Off-the-Shelf

Nationwide rates for HCPCS L0469

Thoracic-lumbar-sacral orthosis (TLSO), sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf

Rates data updated July 2026.

Facilitymedian $398 · 10th–90th $200$1,1220%10%20%10th90th$398Professionalmedian $295 · 10th–90th $182$4900%10%20%10th90th$295$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
Facility
Modifier
Global
Typical Low
$169.82
Median
$245.47
Typical High
$398.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$234.42
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$446.68
Typical High
$1,096.48
BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$331.13
Typical High
$562.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$1,445.44
Cigna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$537.03
United
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$302.00
Typical High
$933.25
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$281.84
Typical High
$446.68