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Lateral Thoracic Extension for TLSO (Low Profile)

Maine 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?

$191

Typical negotiated rate. In Maine, July 2026.

Insurers have agreed to pay about $191 for this service. The price depends on where it is billed: about $182 from a physician practice, and about $309 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$182$166 to $257
FacilityA hospital or hospital-owned outpatient department$309$195 to $347

How much rates vary

Facilitymedian $309 · 10th to 90th $186 to $372Professionalmedian $182 · 10th to 90th $138 to $257
$100.0$200.0$500.0$1.0Kfacility $309professional $182

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. 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
Global
Typical Low
$128.82
Median
$177.83
Typical High
$245.47
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$346.74
Typical High
$398.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$229.09
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$309.03
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$177.83
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$181.97
Typical High
$194.98
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$257.04
Typical High
$257.04

Where Maine 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.

Maine $191 · 18th 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.