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TLSO, Initial Orthosis Only

Hawaii rates for HCPCS L1200

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

Rates data updated July 2026.

How much does TLSO, Initial Orthosis Only cost?

$3,467

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $3,467 for this service. Most negotiated rates run $1,096 to $3,467.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,148 · 10th to 90th $871 to $2,692Professionalmedian $3,467 · 10th to 90th $603 to $3,631
$1K$2K$5Kfacility $1,148professional $3,467

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$1,096.48
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$2,691.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$3,162.28
Typical High
$4,265.80
HMSA
Setting
Professional
Modifier
Global
Typical Low
$3,467.37
Median
$3,467.37
Typical High
$3,630.78
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$3,467.37
Typical High
$4,786.30
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,096.48
Typical High
$1,148.15
United
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,479.11
Typical High
$4,168.69

Where Hawaii sits

The same service costs 4.8 times more in Hawaii 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.

Hawaii· 1st of 51

$3,467

HI $3,467DC $724

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.