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Lateral Thoracic Extension for TLSO (Low Profile)

Hawaii rates for HCPCS L1210

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

Rates data updated October 2026.

How much does Lateral Thoracic Extension for TLSO (Low Profile) cost?

$479

Typical negotiated rate. In Hawaii, October 2026.

Insurers have agreed to pay about $479 for this service. Most negotiated rates run $324 to $501.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $372 · 10th to 90th $191 to $372Professionalmedian $479 · 10th to 90th $295 to $513
$200$500facility $372professional $479

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
Professional
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$371.54
Typical High
$371.54
Cigna
Setting
Professional
Modifier
None
Typical Low
$512.86
Median
$512.86
Typical High
$512.86
HMSA
Setting
Professional
Modifier
None
Typical Low
$478.63
Median
$478.63
Typical High
$501.19
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$288.40
Median
$478.63
Typical High
$616.60
United
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$512.86
Typical High
$512.86
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$295.12
Typical High
$295.12

Where Hawaii sits

The same service costs 3.5 times more in Hawaii than in Florida. 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.

Hawaii· 1st of 51

$479

HI $479FL $138

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.