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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 October 2026.

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

$324

Typical negotiated rate. In South Dakota, October 2026.

Insurers have agreed to pay about $324 for this service. The price depends on where it is billed: about $316 from a physician practice, and about $389 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$316$263 to $389
FacilityA hospital or hospital-owned outpatient department$389$275 to $457

How much rates vary

Facilitymedian $389 · 10th to 90th $200 to $741Professionalmedian $316 · 10th to 90th $155 to $427
$200$500$1Kfacility $389professional $316

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Aetna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$269.15
Typical High
$269.15
Cigna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$331.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$338.84
Typical High
$436.52
Medica
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$457.09
Typical High
$741.31
Medica
Setting
Professional
Modifier
None
Typical Low
$154.88
Median
$208.93
Typical High
$1,949.84
Midlands
Setting
Professional
Modifier
None
Typical Low
$323.59
Median
$323.59
Typical High
$323.59
Midlands
Setting
Facility
Modifier
None
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Midlands
Setting
Professional
Modifier
None
Typical Low
$269.15
Median
$269.15
Typical High
$707.95
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$338.84
Median
$389.05
Typical High
$457.09
United
Setting
Professional
Modifier
None
Typical Low
$123.03
Median
$162.18
Typical High
$263.03
Wellmark
Setting
Professional
Modifier
None
Typical Low
$295.12
Median
$295.12
Typical High
$295.12

Where South Dakota sits

The same service costs 3.5 times more in Hawaii than in Florida. 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· 6th of 51

$324

HI $479FL $138

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.