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Lumbar Derotation Pad for TLSO (Low Profile)

Connecticut rates for HCPCS L1240

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

Rates data updated July 2026.

Facilitymedian $63 · 10th–90th $44$980%20%10th90th$63Professionalmedian $48 · 10th–90th $38$1000%10%20%10th90th$48$50.0$100.0$200.0$500.0

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

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$45.71
Typical High
$100.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$117.49
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$56.23
Typical High
$138.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$70.79
Typical High
$100.00
Health New England
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Health New England
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
United
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$50.12
Typical High
$58.88
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$47.86
Typical High
$83.18