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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 July 2026.

Facilitymedian $661 · 10th–90th $603$1,8200%20%40%10th90th$661Professionalmedian $933 · 10th–90th $692$1,7780%10%10th90th$933$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
$602.56
Median
$602.56
Typical High
$602.56
Aetna
Setting
Professional
Modifier
Global
Typical Low
$602.56
Median
$831.76
Typical High
$1,288.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,174.90
Typical High
$1,819.70
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1,174.90
Median
$1,698.24
Typical High
$2,344.23
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$1,778.28
Typical High
$1,778.28
United
Setting
Facility
Modifier
Global
Typical Low
$741.31
Median
$1,479.11
Typical High
$1,819.70
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,000.00
Typical High
$1,778.28