go back

Lateral Thoracic Extension for TLSO (Low Profile)

Oklahoma rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $155 · 10th–90th $135$3550%20%10th90th$155Professionalmedian $178 · 10th–90th $123$2570%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
$134.90
Median
$138.04
Typical High
$138.04
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$138.04
Typical High
$181.97
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
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
$323.59
Medica
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$1,548.82
Medica
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$147.91
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$239.88
Typical High
$338.84
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$141.25
Typical High
$208.93