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TLSO, Initial Orthosis Only

Missouri rates for HCPCS L1200

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

Rates data updated July 2026.

Facilitymedian $1,660 · 10th–90th $1,072$3,5480%20%10th90th$1,660Professionalmedian $1,148 · 10th–90th $871$2,4550%20%40%10th90th$1,148$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
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,122.02
Typical High
$10,232.93
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,412.54
Typical High
$1,548.82
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$7,244.36
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,148.15
Typical High
$1,905.46
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$2,089.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,778.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
Medica
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$1,659.59
Typical High
$9,772.37
Medica
Setting
Professional
Modifier
Global
Typical Low
$676.08
Median
$1,023.29
Typical High
$13,803.84
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,659.59
Typical High
$2,089.30
United
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,000.00
Typical High
$1,778.28