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Lateral Thoracic Extension for TLSO (Low Profile)

Wyoming rates for HCPCS L1210

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

Rates data updated July 2026.

Facilitymedian $162 · 10th–90th $145$3800%20%10th90th$162Professionalmedian $219 · 10th–90th $148$3800%20%10th90th$219$100.0$200.0

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
$154.88
Median
$218.78
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
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
United
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$147.91
Typical High
$323.59
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$147.91
Typical High
$223.87