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TLSO, One-Piece Shell without Liner, Custom Fabricated

New York 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?

$1,000

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $1,000 for this service. The price depends on where it is billed: about $1,000 from a physician practice, and about $1,175 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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,000$851 to $1,549
FacilityA hospital or hospital-owned outpatient department$1,175$912 to $1,995

How much rates vary

Facilitymedian $1,175 · 10th to 90th $776 to $2,951Professionalmedian $1,000 · 10th to 90th $724 to $2,818
$1K$2K$5K$10K$20K$50Kfacility $1,175professional $1,000

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$851.14
Typical High
$2,187.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$851.14
Typical High
$1,258.93
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,000.00
Typical High
$3,235.94
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$1,621.81
Typical High
$1,621.81
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$1,621.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$2,511.89
Cigna
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$741.31
Typical High
$1,148.15
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$3,235.94
Typical High
$7,585.78
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$2,089.30
Typical High
$3,715.35
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$954.99
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,174.90
Typical High
$1,230.27
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$1,202.26
Median
$1,905.46
Typical High
$2,238.72
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$954.99
Typical High
$2,818.38
United
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$1,288.25
Typical High
$3,162.28
Univera
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$1,096.48
Typical High
$1,174.90
Univera
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,174.90
Typical High
$1,230.27

Where New York 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.

New York· 26th of 51

$1,000

KS $2,042DC $661

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.