TLSO, Sagittal-Coronal Control, Modular, Two Shells
Nationwide rates for HCPCS L0491
Thoracic-lumbar-sacral orthosis (TLSO), sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
Rates data updated July 2026.
How much does TLSO, Sagittal-Coronal Control, Modular, Two Shells cost?
$525
Typical negotiated rate. Nationwide, July 2026.
Insurers have agreed to pay about $525 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $692 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 66 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
$501
$437 to $794
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$692
$468 to $977
How much rates vary
Facilitymedian $692 · 10th to 90th $389 to $2,188Professionalmedian $501 · 10th to 90th $389 to $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
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
$371.54
Median
$478.63
Typical High
$870.96
Facility
Global
$371.54
$478.63
$870.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$478.63
Typical High
$812.83
Professional
Global
$371.54
$478.63
$812.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$524.81
Typical High
$1,862.09
Facility
Global
$380.19
$524.81
$1,862.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$501.19
Typical High
$1,122.02
Professional
Global
$478.63
$501.19
$1,122.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$575.44
Typical High
$3,548.13
Facility
Global
$575.44
$575.44
$3,548.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$1,348.96
Professional
Global
$416.87
$416.87
$1,348.96
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$588.84
Typical High
$1,122.02
Facility
Global
$316.23
$588.84
$1,122.02
United
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$457.09
Typical High
$831.76
Professional
Global
$323.59
$457.09
$831.76
What it costs in each state
The same service costs 2.7 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.
Touch or drag across the chart to see any state's rate.
KS $1,000DC $372
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.
See more rates by state
Want provider-level rates data or 24+ months of history? We offer custom data extracts for a reasonable fee. To learn more, please email us.