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Lumbar Derotation Pad for TLSO (Low Profile)

Alaska rates for HCPCS L1240

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), lumbar derotation pad

Rates data updated July 2026.

How much does Lumbar Derotation Pad for TLSO (Low Profile) cost?

$63.10

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $63.10 for this service. The price depends on where it is billed: about $66.07 from a physician practice, and about $52.48 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 6 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$66.07$52.48 to $132
FacilityA hospital or hospital-owned outpatient department$52.48$28.18 to $120

How much rates vary

Facilitymedian $52 · 10th to 90th $28 to $132Professionalmedian $66 · 10th to 90th $46 to $186
$50$100$200$500facility $52professional $66

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
Professional
Modifier
Global
Typical Low
$45.71
Median
$52.48
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$158.49
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$79.43
Typical High
$131.83
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$138.04
Typical High
$288.40
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$131.83
Typical High
$138.04
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$131.83
Typical High
$138.04
Providence
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$120.23
Providence
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$63.10
Typical High
$89.13
United
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$48.98
Typical High
$54.95
United
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$67.61
Typical High
$338.84

Where Alaska sits

The same service costs 3.7 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.

Alaska· 17th of 51

$63.10

HI $148DC $39.81

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.