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TLSO, Initial Orthosis Only

Texas rates for HCPCS L1200

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

Rates data updated July 2026.

Facilitymedian $1,514 · 10th–90th $851$5,4950%10%20%10th90th$1,514Professionalmedian $977 · 10th–90th $851$1,5140%50%10th90th$977$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$4.27
Median
$933.25
Typical High
$2,187.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$851.14
Median
$954.99
Typical High
$1,584.89
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,479.11
Typical High
$1,479.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$977.24
Baylor Scott & White
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$1,548.82
Typical High
$2,089.30
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,659.59
Typical High
$2,089.30
Christus
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$2,089.30
Typical High
$2,089.30
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$2,884.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$11,481.54
Median
$11,481.54
Typical High
$11,481.54
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$14,125.38
Median
$14,125.38
Typical High
$14,125.38
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,584.89
Typical High
$2,691.53
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$1,230.27
Median
$1,949.84
Typical High
$2,398.83
Molina
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,096.48
Typical High
$1,122.02
Providence
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$1,513.56
Typical High
$2,691.53
Providence
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
United
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,659.59
Typical High
$2,089.30
United
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$1,071.52
Typical High
$1,258.93
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$2,089.30
Typical High
$2,818.38