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TLSO, Initial Orthosis Only

South Carolina rates for HCPCS L1200

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

Rates data updated July 2026.

Facilitymedian $1,175 · 10th–90th $933$2,6300%20%10th90th$1,175Professionalmedian $977 · 10th–90th $776$1,6980%20%10th90th$977$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
$977.24
Median
$977.24
Typical High
$977.24
Aetna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$977.24
Typical High
$1,698.24
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$1,548.82
Typical High
$1,995.26
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,778.28
Typical High
$1,995.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,122.02
Median
$1,778.28
Typical High
$2,454.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,174.90
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$2,511.89
Medcost
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,071.52
Medcost
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,513.56
Typical High
$3,090.30
Medcost
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,318.26
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,148.15
Typical High
$2,398.83
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$977.24
Typical High
$1,318.26