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TLSO, Initial Orthosis Only

New Hampshire rates for HCPCS L1200

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

Rates data updated July 2026.

How much does TLSO, Initial Orthosis Only cost?

$1,413

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $1,413 for this service. The price depends on where it is billed: about $1,259 from a physician practice, and about $2,138 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,259$1,148 to $1,820
FacilityA hospital or hospital-owned outpatient department$2,138$1,413 to $2,291

How much rates vary

Facilitymedian $2,138 · 10th to 90th $1,175 to $2,630Professionalmedian $1,259 · 10th to 90th $871 to $1,820
$1K$2K$5Kfacility $2,138professional $1,259

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,412.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$724.44
Median
$1,174.90
Typical High
$1,412.54
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,584.89
Typical High
$1,584.89
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$2,290.87
Typical High
$2,630.27
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,174.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,548.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$1,819.70
Median
$1,819.70
Typical High
$3,388.44
United
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$1,023.29
Typical High
$1,174.90
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,230.27
Typical High
$1,819.70
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$3,019.95

Where New Hampshire sits

The same service costs 4.8 times more in Hawaii than in Washington, DC. 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.

New Hampshire· 13th of 51

$1,413

HI $3,467DC $724

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.