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TLSO, Initial Orthosis Only

North Dakota rates for HCPCS L1200

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

Rates data updated July 2026.

Facilitymedian $1,549 · 10th–90th $1,514$2,8180%50%10th90th$1,549Professionalmedian $1,995 · 10th–90th $1,072$2,5700%10%20%10th90th$1,995$1.0K$2.0K$5.0K$10.0K

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
$1,513.56
Median
$1,548.82
Typical High
$1,548.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,513.56
Typical High
$8,912.51
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$2,344.23
Typical High
$2,570.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,174.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$2,511.89
Typical High
$3,090.30
Medica
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,905.46
Typical High
$9,772.37
Medica
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$977.24
Typical High
$2,089.30
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$2,884.03
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,348.96
Typical High
$2,511.89