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Lateral Thoracic Extension for TLSO (Low Profile)

Vermont rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $191 · 10th–90th $110$1950%50%10th90th$191Professionalmedian $166 · 10th–90th $145$2450%20%10th90th$166$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
$144.54
Median
$144.54
Typical High
$245.47
BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$239.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$138.04
Typical High
$190.55
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$194.98
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$223.87
Typical High
$588.84