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Lateral Thoracic Extension for TLSO (Low Profile)

Utah 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?

$195

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $195 for this service. The price depends on where it is billed: about $204 from a physician practice, and about $148 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$204$132 to $363
FacilityA hospital or hospital-owned outpatient department$148$95.50 to $389

How much rates vary

Facilitymedian $148 · 10th to 90th $95 to $389Professionalmedian $204 · 10th to 90th $95 to $1,698
$100$200$500$1Kfacility $148professional $204

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$134.90
Typical High
$1,698.24
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
$190.55
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$288.40
Typical High
$371.54
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$389.05
Typical High
$389.05
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$281.84
Typical High
$346.74
Select Health
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Select Health
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$380.19
Typical High
$398.11
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$398.11
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$165.96
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$147.91
Typical High
$223.87

Where Utah 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.

Utah· 17th of 51

$195

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.