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Lateral Thoracic Extension for TLSO (Low Profile)

Washington, DC rates for HCPCS L1210

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), lateral thoracic extension

Rates data updated July 2026.

Facilitymedian $120 · 10th–90th $120$4790%50%90th$120Professionalmedian $120 · 10th–90th $120$1580%50%90th$120$100.0$200.0$500.0

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
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$144.54
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$204.17
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$204.17
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$257.04
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$281.84