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Anterior Thoracic Extension for TLSO (Low Profile)

South Dakota 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?

$245

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $245 for this service. The price depends on where it is billed: about $245 from a physician practice, and about $251 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$245$178 to $331
FacilityA hospital or hospital-owned outpatient department$251$214 to $302

How much rates vary

Facilitymedian $251 · 10th to 90th $178 to $355Professionalmedian $245 · 10th to 90th $162 to $417
$100$200$500$1Kfacility $251professional $245

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
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$177.83
Typical High
$269.15
Cigna
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$288.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$416.87
Medica
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$263.03
Typical High
$489.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$177.83
Typical High
$1,659.59
Midlands
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$281.84
Midlands
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40
Midlands
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$467.74
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$263.03
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$144.54
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$190.55
Typical High
$338.84
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04

Where South Dakota 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.

South Dakota· 5th of 51

$245

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.