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Lateral Thoracic Extension for TLSO (Low Profile)

New Jersey rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $135 · 10th–90th $135$3980%50%90th$135Professionalmedian $170 · 10th–90th $123$3890%10%10th90th$170$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
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$154.88
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$190.55
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$371.54
Typical High
$524.81
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$194.98
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$208.93
Typical High
$380.19