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Milwaukee Type Superstructure for TLSO (Low Profile)

Alaska rates for HCPCS L1230

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), Milwaukee type superstructure

Rates data updated July 2026.

Facilitymedian $398 · 10th–90th $204$6760%20%40%10th90th$398Professionalmedian $479 · 10th–90th $339$8910%10%10th90th$479$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$398.11
Typical High
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$758.58
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$588.84
Typical High
$676.08
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$660.69
Typical High
$1,949.84
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$630.96
Typical High
$660.69
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$524.81
Median
$630.96
Typical High
$660.69
Providence
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$741.31
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$398.11
Typical High
$616.60
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$363.08
Typical High
$398.11
United
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$489.78
Typical High
$1,621.81