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TLSO, Initial Orthosis Only

Vermont 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 $661$1,4790%20%40%10th90th$1,175Professionalmedian $1,122 · 10th–90th $1,023$1,5850%20%40%10th90th$1,122$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,023.29
Median
$1,023.29
Typical High
$1,174.90
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,698.24
Median
$1,698.24
Typical High
$1,698.24
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$1,174.90
Typical High
$1,548.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$870.96
Median
$870.96
Typical High
$1,174.90
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$1,621.81
Median
$1,621.81
Typical High
$2,041.74
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$1,096.48
Typical High
$1,479.11
United
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$1,348.96
Typical High
$4,168.69