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

Montana 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 October 2026.

How much does TLSO, Sagittal-Coronal Control, Rigid Frame, Off-the-Shelf cost?

$339

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $468 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$295$257 to $468
FacilityA hospital or hospital-owned outpatient department$468$316 to $14,454

How much rates vary

Facilitymedian $468 · 10th to 90th $251 to $14,791Professionalmedian $295 · 10th to 90th $79 to $468
$100$200$500$1K$2K$5K$10Kfacility $468professional $295

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$223.87
Typical High
$354.81
Cigna
Setting
Facility
Modifier
None
Typical Low
$407.38
Median
$467.74
Typical High
$467.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$436.52
Median
$467.74
Typical High
$467.74
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$251.19
Median
$489.78
Typical High
$15,488.17
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$251.19
Median
$316.23
Typical High
$15,488.17
Providence
Setting
Facility
Modifier
None
Typical Low
$251.19
Median
$467.74
Typical High
$467.74
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$263.03
Typical High
$467.74
United
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$257.04
Typical High
$426.58

Where Montana sits

The same service costs 3.0 times more in Hawaii than in Utah. 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.

Montana· 14th of 51

$339

HI $661UT $224

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.