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TLSO, Sagittal-Coronal Control, Modular, Three Shells

Arkansas rates for HCPCS L0492

Thoracic-lumbar-sacral orthosis (TLSO), sagittal-coronal control, modular segmented spinal system, three 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 October 2026.

How much does TLSO, Sagittal-Coronal Control, Modular, Three Shells cost?

$525

Typical negotiated rate. In Arkansas, October 2026.

Insurers have agreed to pay about $525 for this service. The price depends on where it is billed: about $525 from a physician practice, and about $380 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 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$525$302 to $692
FacilityA hospital or hospital-owned outpatient department$380$380 to $617

How much rates vary

Facilitymedian $380 · 10th to 90th $339 to $724Professionalmedian $525 · 10th to 90th $269 to $692
$200$500facility $380professional $525

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
$338.84
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$309.03
Median
$338.84
Typical High
$338.84
BCBS Arkansas
Setting
Professional
Modifier
None
Typical Low
$524.81
Median
$575.44
Typical High
$691.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$380.19
Median
$380.19
Typical High
$489.78
Cigna
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$275.42
Typical High
$380.19
United
Setting
Facility
Modifier
None
Typical Low
$616.60
Median
$724.44
Typical High
$724.44
United
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$281.84
Typical High
$416.87

Where Arkansas sits

The same service costs 2.4 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.

Arkansas· 12th of 51

$525

HI $661DE $275

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.