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TLSO, Initial Orthosis Only

Arizona rates for HCPCS L1200

Thoracic-lumbar-sacral orthosis (TLSO), inclusive of furnishing initial orthosis only

Rates data updated July 2026.

Facilitymedian $2,042 · 10th–90th $631$5,2480%10%10th90th$2,042Professionalmedian $1,023 · 10th–90th $794$2,4550%20%40%10th90th$1,023$2.0$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,023.29
Typical High
$1,584.89
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,862.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$2,630.27
Typical High
$5,128.61
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$2,398.83
Typical High
$4,897.79
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
Medica
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$1,621.81
Typical High
$9,772.37
Medica
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$870.96
Typical High
$13,803.84
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,905.46
Typical High
$2,398.83
United
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$870.96
Typical High
$1,318.26