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Lateral Thoracic Extension for TLSO (Low Profile)

Virginia 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?

$178

Typical negotiated rate. In Virginia, October 2026.

Insurers have agreed to pay about $178 for this service. The price depends on where it is billed: about $178 from a physician practice, and about $204 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$178$148 to $191
FacilityA hospital or hospital-owned outpatient department$204$191 to $302

How much rates vary

Facilitymedian $204 · 10th to 90th $145 to $457Professionalmedian $178 · 10th to 90th $138 to $245
$100$200$500$1K$2K$5K$10Kfacility $204professional $178

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$144.54
Typical High
$144.54
Aetna
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$144.54
Typical High
$144.54
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$302.00
Median
$302.00
Typical High
$316.23
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$177.83
Typical High
$199.53
CareFirst
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$204.17
Cigna
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$190.55
Typical High
$190.55
Cigna
Setting
Professional
Modifier
None
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$302.00
Typical High
$389.05
Medcost
Setting
Professional
Modifier
None
Typical Low
$177.83
Median
$194.98
Typical High
$275.42
Medcost
Setting
Facility
Modifier
None
Typical Low
$104.71
Median
$162.18
Typical High
$194.98
Medcost
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$173.78
Typical High
$380.19
Sentara
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$208.93
Typical High
$645.65
Sentara
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$223.87
Typical High
$457.09
United
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$194.98
Typical High
$398.11
United
Setting
Professional
Modifier
None
Typical Low
$131.83
Median
$147.91
Typical High
$223.87
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$60.26
Median
$72.44
Typical High
$72.44
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$23.99
Median
$28.84
Typical High
$29.51
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$18.20
Median
$21.88
Typical High
$21.88
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$12.02
Median
$14.45
Typical High
$14.45
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$18.20
Median
$18.20
Typical High
$22.91
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$131.83
Median
$138.04
Typical High
$144.54

Where Virginia 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.

Virginia· 31st of 51

$178

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.