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Anterior Thoracic Extension for TLSO (Low Profile)

Utah 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?

$151

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $151 for this service. The price depends on where it is billed: about $151 from a physician practice, and about $126 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$151$115 to $269
FacilityA hospital or hospital-owned outpatient department$126$81.28 to $263

How much rates vary

Facilitymedian $126 · 10th to 90th $81 to $263Professionalmedian $151 · 10th to 90th $81 to $1,445
$100$200$500$1Kfacility $126professional $151

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$128.82
Typical High
$1,445.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$186.21
Molina
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$190.55
Typical High
$245.47
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$263.03
Typical High
$263.03
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$186.21
Typical High
$338.84
Select Health
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Select Health
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$263.03
Typical High
$309.03
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$263.03
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$141.25
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$125.89
Typical High
$190.55

Where Utah 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.

Utah· 25th of 51

$151

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.