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TLSO, Initial Orthosis Only

New Mexico rates for HCPCS L1200

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

Rates data updated July 2026.

Facilitymedian $1,349 · 10th–90th $562$2,2910%10%10th90th$1,349Professionalmedian $1,230 · 10th–90th $871$2,1380%10%20%10th90th$1,230$100.0$200.0$500.0$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
$1,000.00
Median
$1,000.00
Typical High
$1,000.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$1,071.52
Typical High
$10,232.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,621.81
Typical High
$1,949.84
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
$870.96
Median
$870.96
Typical High
$3,162.28
Molina
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$2,041.74
Typical High
$3,019.95
Providence
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$1,479.11
Typical High
$2,290.87
Providence
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$2,454.71
United
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$977.24
Typical High
$2,398.83
United
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$870.96
Typical High
$1,318.26