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TLSO, Initial Orthosis Only

Michigan rates for HCPCS L1200

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

Rates data updated October 2026.

How much does TLSO, Initial Orthosis Only cost?

$1,778

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $1,778 for this service. The price depends on where it is billed: about $1,738 from a physician practice, and about $3,311 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,738$1,230 to $2,138
FacilityA hospital or hospital-owned outpatient department$3,311$1,175 to $6,166

How much rates vary

Facilitymedian $3,311 · 10th to 90th $1,175 to $9,333Professionalmedian $1,738 · 10th to 90th $1,000 to $2,188
$1K$2K$5K$10K$20Kfacility $3,311professional $1,738

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1,258.93
Median
$2,137.96
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$630.96
Median
$630.96
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$251.19
Median
$251.19
Typical High
$426.58
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$186.21
Median
$186.21
Typical High
$323.59
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$125.89
Median
$125.89
Typical High
$213.80
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$2,630.27
Median
$6,309.57
Typical High
$12,022.64
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$2,041.74
Median
$2,137.96
Typical High
$2,137.96
CareSource
Setting
Facility
Modifier
None
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$1,258.93
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$1,174.90
Typical High
$2,187.76
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$1,230.27
Median
$4,168.69
Typical High
$5,370.32
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$1,230.27
Median
$1,698.24
Typical High
$2,187.76
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
Priority Health
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Priority Health
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$1,174.90
Typical High
$1,995.26
United
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$1,479.11
Typical High
$2,398.83
United
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$1,023.29
Typical High
$1,445.44

Where Michigan sits

The same service costs 4.0 times more in Hawaii than in Pennsylvania. 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.

Michigan· 13th of 51

$1,778

HI $3,467PA $871

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.