Thoracic-lumbar-sacral orthosis (TLSO), sagittal-coronal control, one-piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the T-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $136.91 | $136.91 | $157.02 | |
Cigna
| Facility | $227.96 | $227.96 | $227.96 | |
Cigna
| Professional | $166.41 | $166.41 | $227.96 | |
United
| Professional | $125.85 | $165.97 | $250.01 |