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Lumbar Derotation Pad for TLSO (Low Profile)

Arizona 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?

$50.12

Typical negotiated rate. In Arizona, July 2026.

Insurers have agreed to pay about $50.12 for this service. The price depends on where it is billed: about $48.98 from a physician practice, and about $100 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$48.98$43.65 to $63.10
FacilityA hospital or hospital-owned outpatient department$100$46.77 to $158

How much rates vary

Facilitymedian $100 · 10th to 90th $31 to $245Professionalmedian $49 · 10th to 90th $40 to $123
$50$100$200$500facility $100professional $49

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
$39.81
Median
$48.98
Typical High
$67.61
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$91.20
BCBS
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$131.83
Typical High
$251.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$117.49
Typical High
$245.47
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
$63.10
Medica
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$77.62
Typical High
$467.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$43.65
Typical High
$602.56
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$95.50
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$43.65
Typical High
$66.07

Where Arizona 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.

Arizona· 40th of 51

$50.12

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.