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Lateral Thoracic Extension for TLSO (Low Profile)

Oregon rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $288 · 10th–90th $234$3310%50%10th90th$288Professionalmedian $219 · 10th–90th $132$3310%10%20%10th90th$219$0.2$2.0$20.0$200.0$2.0K

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
Professional
Modifier
Global
Typical Low
$120.23
Median
$177.83
Typical High
$204.17
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
$138.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$645.65
Typical High
$794.33
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$223.87
Typical High
$309.03
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$239.88
Typical High
$331.13
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$288.40
Typical High
$309.03
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$295.12
Typical High
$389.05
Providence
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$251.19
Typical High
$398.11
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$257.04
Typical High
$309.03
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$302.00
Typical High
$1,148.15
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$0.23
Median
$162.18
Typical High
$478.63
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$147.91
Typical High
$281.84