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Anterior Thoracic Extension for TLSO (Low Profile)

Hawaii rates for HCPCS L1220

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

Rates data updated July 2026.

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

$417

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $417 for this service. Most negotiated rates run $186 to $417.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $158 · 10th to 90th $123 to $324Professionalmedian $417 · 10th to 90th $112 to $437
$200$500facility $158professional $417

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$147.91
Cigna
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$323.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$380.19
Typical High
$512.86
HMSA
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$416.87
Typical High
$436.52
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$416.87
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$141.25
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$208.93
Typical High
$512.86

Where Hawaii sits

The same service costs 3.6 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.

Hawaii· 1st of 51

$417

HI $417DC $115

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.