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Lateral Thoracic Extension for TLSO (Low Profile)

Kentucky rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $162 · 10th–90th $132$4570%20%10th90th$162Professionalmedian $158 · 10th–90th $132$1860%20%40%10th90th$158$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$154.88
Typical High
$173.78
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$302.00
Typical High
$316.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$173.78
Typical High
$181.97
CareSource
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$398.11
Typical High
$512.86
CareSource
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$371.54
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$457.09
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$234.42
Typical High
$1,621.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$199.53
Typical High
$251.19
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$144.54
Typical High
$194.98
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$223.87