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TLSO, Initial Orthosis Only

New Jersey 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?

$871

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $871 for this service. The price depends on where it is billed: about $871 from a physician practice, and about $1,175 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$871$724 to $1,820
FacilityA hospital or hospital-owned outpatient department$1,175$1,175 to $1,479

How much rates vary

Facilitymedian $1,175 · 10th to 90th $1,096 to $1,820Professionalmedian $871 · 10th to 90th $603 to $1,820
$1K$2Kfacility $1,175professional $871

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$691.83
Aetna
Setting
Professional
Modifier
None
Typical Low
$602.56
Median
$602.56
Typical High
$776.25
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$302.00
Median
$302.00
Typical High
$380.19
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$120.23
Median
$120.23
Typical High
$154.88
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$89.13
Median
$89.13
Typical High
$114.82
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$60.26
Median
$60.26
Typical High
$77.62
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,819.70
Cigna
Setting
Professional
Modifier
None
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$1,174.90
Median
$2,344.23
Typical High
$2,344.23
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$1,819.70
Median
$1,819.70
Typical High
$1,819.70
United
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$1,479.11
Typical High
$2,041.74
United
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$933.25
Typical High
$1,737.80

Where New Jersey 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.

New Jersey· 49th of 51

$871

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.