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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 October 2026.

How much does TLSO, Initial Orthosis Only cost?

$1,175

Typical negotiated rate. In Missouri, October 2026.

Insurers have agreed to pay about $1,175 for this service. The price depends on where it is billed: about $1,175 from a physician practice, and about $1,862 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,175$1,023 to $1,259
FacilityA hospital or hospital-owned outpatient department$1,862$1,175 to $7,413

How much rates vary

Facilitymedian $1,862 · 10th to 90th $1,072 to $9,772Professionalmedian $1,175 · 10th to 90th $871 to $1,905
$1K$2K$5K$10Kfacility $1,862professional $1,175

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
$1,071.52
Median
$1,071.52
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,071.52
Median
$1,122.02
Typical High
$1,230.27
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$9,549.93
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$1,023.29
Median
$1,258.93
Typical High
$1,698.24
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$776.25
Median
$851.14
Typical High
$1,445.44
BCBS Kansas City
Setting
Professional
Modifier
None
Typical Low
$1,258.93
Median
$1,258.93
Typical High
$2,089.30
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,445.44
Cigna
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
Medica
Setting
Facility
Modifier
None
Typical Low
$1,071.52
Median
$2,041.74
Typical High
$9,772.37
Medica
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$1,023.29
Typical High
$13,803.84
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
$676.08
Median
$1,000.00
Typical High
$1,513.56
5 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$537.03
Median
$562.34
Typical High
$616.60
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$213.80
Median
$223.87
Typical High
$245.47
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$162.18
Median
$169.82
Typical High
$181.97
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$107.15
Median
$112.20
Typical High
$123.03
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$114.82
Median
$114.82
Typical High
$1,174.90

Where Missouri 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.

Missouri· 31st of 51

$1,175

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.