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Lateral Thoracic Extension for TLSO (Low Profile)

Nebraska rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $302 · 10th–90th $148$1,5490%20%10th90th$302Professionalmedian $155 · 10th–90th $138$2450%20%40%10th90th$155$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
$186.21
Median
$186.21
Typical High
$186.21
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$154.88
Typical High
$186.21
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$281.84
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$331.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$338.84
Typical High
$616.60
Medica
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$331.13
Typical High
$1,548.82
Medica
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$288.40
Midlands
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$794.33
Midlands
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$741.31
Typical High
$794.33
United
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$302.00
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$147.91
Typical High
$245.47