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Lateral Thoracic Extension for TLSO (Low Profile)

Delaware rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $191 · 10th–90th $0$1950%50%10th90th$191Professionalmedian $135 · 10th–90th $120$1,5140%20%40%10th90th$135$0.2$1.0$5.0$20.0$100.0$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
Professional
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$1,513.56
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
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$0.23
Median
$165.96
Typical High
$194.98
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$147.91
Typical High
$245.47