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Lateral Thoracic Extension for TLSO (Low Profile)

North Dakota rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $288 · 10th–90th $204$4790%50%10th90th$288Professionalmedian $363 · 10th–90th $178$4790%20%10th90th$363$100.0$200.0$500.0$1.0K

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
$204.17
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$204.17
Typical High
$1,513.56
BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$436.52
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$338.84
Typical High
$426.58
Medica
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$288.40
Typical High
$1,548.82
Medica
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$162.18
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$204.17
Typical High
$363.08