go back

Milwaukee Type Superstructure for TLSO (Low Profile)

South Carolina 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 $316$8710%20%10th90th$398Professionalmedian $372 · 10th–90th $288$5620%20%10th90th$372$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
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$371.54
Typical High
$562.34
BCBS
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$588.84
Typical High
$660.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$549.54
Typical High
$812.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$398.11
Typical High
$446.68
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$870.96
Medcost
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$323.59
Typical High
$436.52
Medcost
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$537.03
Typical High
$1,071.52
Medcost
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
Molina
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$436.52
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$380.19
Typical High
$870.96
United
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$316.23
Typical High
$446.68