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TLSO, Initial Orthosis Only

South Dakota 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?

$2,042

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $2,042 for this service. The price depends on where it is billed: about $2,042 from a physician practice, and about $2,291 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,042$1,413 to $2,239
FacilityA hospital or hospital-owned outpatient department$2,291$1,862 to $2,455

How much rates vary

Facilitymedian $2,291 · 10th to 90th $1,413 to $3,981Professionalmedian $2,042 · 10th to 90th $851 to $2,692
$1K$2K$5K$10Kfacility $2,291professional $2,042

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
$1,548.82
Median
$1,548.82
Typical High
$1,548.82
Aetna
Setting
Professional
Modifier
None
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,513.56
Cigna
Setting
Facility
Modifier
None
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$2,290.87
Cigna
Setting
Professional
Modifier
None
Typical Low
$2,238.72
Median
$2,511.89
Typical High
$3,090.30
Medica
Setting
Facility
Modifier
None
Typical Low
$1,412.54
Median
$2,454.71
Typical High
$3,981.07
Medica
Setting
Professional
Modifier
None
Typical Low
$851.14
Median
$1,258.93
Typical High
$13,803.84
Midlands
Setting
Professional
Modifier
None
Typical Low
$2,238.72
Median
$2,238.72
Typical High
$2,238.72
Midlands
Setting
Facility
Modifier
None
Typical Low
$2,290.87
Median
$2,290.87
Typical High
$2,290.87
Midlands
Setting
Professional
Modifier
None
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$3,801.89
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$1,819.70
Median
$2,137.96
Typical High
$2,454.71
United
Setting
Professional
Modifier
None
Typical Low
$741.31
Median
$977.24
Typical High
$1,548.82
Wellmark
Setting
Professional
Modifier
None
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74

Where South Dakota 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.

South Dakota· 8th of 51

$2,042

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.