TLSO, One-Piece Shell without Liner, Custom Fabricated
Washington, DC rates for HCPCS L0480
Thoracic-lumbar-sacral orthosis (TLSO), triplanar control, one-piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or CAD-CAM model, custom fabricated
Rates data updated July 2026.
How much does TLSO, One-Piece Shell without Liner, Custom Fabricated cost?
$661
Typical negotiated rate. In Washington, DC, July 2026.
Insurers have agreed to pay about $661 for this service. The price depends on where it is billed: about $661 from a physician practice, and about $661 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 5 insurance carriers under federal price transparency rules.
Where it's billed changes the price
Billed by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$661
$661 to $912
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$661
$661 to $661
How much rates vary
Facilitymedian $661 · 10th to 90th $661 to $2,630Professionalmedian $661 · 10th to 90th $661 to $912
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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Facility
Global
$660.69
$660.69
$660.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$912.01
Professional
Global
$660.69
$660.69
$912.01
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$1,122.02
Professional
Global
$891.25
$891.25
$1,122.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,023.29
Facility
Global
$1,023.29
$1,023.29
$1,023.29
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$1,096.48
Professional
Global
$741.31
$741.31
$1,096.48
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,380.38
Typical High
$3,162.28
Professional
Global
$1,071.52
$1,380.38
$3,162.28
United
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$2,630.27
Typical High
$2,630.27
Facility
Global
$2,630.27
$2,630.27
$2,630.27
United
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$851.14
Typical High
$1,548.82
Professional
Global
$537.03
$851.14
$1,548.82
Where Washington, DC sits
The same service costs 3.1 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.