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TLSO, Triplanar Control, Hyperextension, Prefabricated

New Jersey rates for HCPCS L0472

Thoracic-lumbar-sacral orthosis (TLSO), triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment

Rates data updated October 2026.

How much does TLSO, Triplanar Control, Hyperextension, Prefabricated cost?

$269

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $295 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$269$214 to $562
FacilityA hospital or hospital-owned outpatient department$295$295 to $295

How much rates vary

Facilitymedian $295 · 10th to 90th $186 to $562Professionalmedian $269 · 10th to 90th $186 to $562
$200$500facility $295professional $269

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$213.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$186.21
Typical High
$239.88
Cigna
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$295.12
Typical High
$562.34
Cigna
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$218.78
Typical High
$295.12
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$363.08
Median
$724.44
Typical High
$724.44
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
United
Setting
Facility
Modifier
None
Typical Low
$524.81
Median
$524.81
Typical High
$616.60
United
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$288.40
Typical High
$537.03

Where New Jersey sits

The same service costs 3.2 times more in Hawaii than in Delaware. 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.

New Jersey· 39th of 51

$269

HI $708DE $219

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.