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Lateral Thoracic Extension for TLSO (Low Profile)

New Mexico rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $209 · 10th–90th $95$3800%10%10th90th$209Professionalmedian $178 · 10th–90th $145$3630%10%20%10th90th$178$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
$144.54
Median
$144.54
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$177.83
Typical High
$1,698.24
BCBS
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$234.42
Typical High
$281.84
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$436.52
Molina
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$436.52
Typical High
$645.65
Providence
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$218.78
Typical High
$354.81
Providence
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$309.03
United
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$162.18
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$147.91
Typical High
$223.87