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Lateral Thoracic Extension for TLSO (Low Profile)

South Dakota rates for HCPCS L1210

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

Rates data updated July 2026.

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

$269

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $269 for this service. The price depends on where it is billed: about $269 from a physician practice, and about $316 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$269$204 to $372
FacilityA hospital or hospital-owned outpatient department$316$251 to $389

How much rates vary

Facilitymedian $316 · 10th to 90th $200 to $537Professionalmedian $269 · 10th to 90th $186 to $427
$200$500$1Kfacility $316professional $269

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. 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
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$218.78
Typical High
$269.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$331.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$426.58
Medica
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$346.74
Typical High
$741.31
Medica
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$234.42
Typical High
$1,949.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$323.59
Typical High
$323.59
Midlands
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$707.95
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$389.05
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$169.82
Typical High
$245.47
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$245.47
Typical High
$346.74
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$295.12

Where South Dakota sits

The same service costs 4.0 times more in Hawaii than in Washington, DC. 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.

South Dakota· 7th of 51

$269

HI $479DC $120

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.