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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 October 2026.

How much does Lateral Thoracic Extension for TLSO (Low Profile) cost?

$191

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $191 for this service. The price depends on where it is billed: about $191 from a physician practice, and about $191 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$191$138 to $398
FacilityA hospital or hospital-owned outpatient department$191$191 to $195

How much rates vary

Facilitymedian $191 · 10th to 90th $174 to $339Professionalmedian $191 · 10th to 90th $135 to $398
$200$500facility $191professional $191

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$154.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$169.82
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$67.61
Median
$67.61
Typical High
$85.11
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$26.92
Median
$26.92
Typical High
$33.88
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$19.95
Median
$19.95
Typical High
$25.70
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$13.49
Median
$13.49
Typical High
$16.98
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$398.11
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$263.03
Median
$524.81
Typical High
$524.81
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Horizon BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
United
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$194.98
Typical High
$338.84
United
Setting
Professional
Modifier
None
Typical Low
$144.54
Median
$208.93
Typical High
$380.19

Where New Jersey sits

The same service costs 3.5 times more in Hawaii than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 24th of 51

$191

HI $479FL $138

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.