go back

TLSO, Initial Orthosis Only

North Carolina rates for HCPCS L1200

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

Rates data updated July 2026.

Facilitymedian $1,698 · 10th–90th $813$3,8900%20%10th90th$1,698Professionalmedian $1,514 · 10th–90th $851$1,8200%20%40%10th90th$1,514$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
$1,698.24
Median
$1,698.24
Typical High
$1,698.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$1,698.24
Typical High
$1,819.70
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,778.28
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,621.81
Median
$1,949.84
Typical High
$3,890.45
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,513.56
Median
$1,513.56
Typical High
$1,659.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,174.90
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,479.11
Medcost
Setting
Professional
Modifier
Global
Typical Low
$954.99
Median
$1,023.29
Typical High
$1,174.90
Medcost
Setting
Facility
Modifier
Global
Typical Low
$776.25
Median
$1,698.24
Typical High
$2,754.23
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,479.11
Typical High
$1,995.26
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$977.24
Typical High
$1,348.96
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$14,125.38
Median
$14,125.38
Typical High
$14,125.38