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Lateral Thoracic Extension for TLSO (Low Profile)

Indiana rates for HCPCS L1210

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

Rates data updated July 2026.

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

$158

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $302 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$158$145 to $178
FacilityA hospital or hospital-owned outpatient department$302$178 to $302

How much rates vary

Facilitymedian $302 · 10th to 90th $145 to $372Professionalmedian $158 · 10th to 90th $132 to $257
$1.0$10.0$100.0$1.0Kfacility $302professional $158

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$151.36
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$302.00
Typical High
$380.19
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$177.83
Typical High
$302.00
CareSource
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$380.19
Typical High
$446.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$194.98
Typical High
$302.00
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$218.78

Where Indiana sits

The same service costs 4.0 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Indiana $158 · 39th of 51
HI $479DC $120

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.