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Lateral Thoracic Extension for TLSO (Low Profile)

Rhode Island rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $490 · 10th–90th $170$6760%10%20%10th90th$490Professionalmedian $158 · 10th–90th $129$2090%20%10th90th$158$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$144.54
Typical High
$173.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$588.84
Typical High
$691.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$165.96
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$181.97
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$165.96
Typical High
$245.47