go back

Lumbar Derotation Pad for TLSO (Low Profile)

Washington, DC rates for HCPCS L1240

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

Rates data updated October 2026.

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

$52.48

Typical negotiated rate. In Washington, DC, October 2026.

Insurers have agreed to pay about $52.48 for this service. Most negotiated rates run $43.65 to $67.61.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $40 · 10th to 90th $40 to $69Professionalmedian $52 · 10th to 90th $40 to $93
$50$100facility $40professional $52

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$39.81
Typical High
$67.61
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$19.95
Median
$19.95
Typical High
$33.88
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$7.94
Median
$7.94
Typical High
$13.49
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$6.03
Median
$6.03
Typical High
$10.23
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$3.98
Median
$3.98
Typical High
$6.76
CareFirst
Setting
Professional
Modifier
None
Typical Low
$52.48
Median
$52.48
Typical High
$67.61
Cigna
Setting
Facility
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$69.18
Cigna
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$45.71
Typical High
$63.10
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$85.11
Typical High
$194.98
United
Setting
Professional
Modifier
None
Typical Low
$32.36
Median
$52.48
Typical High
$107.15

Where Washington, DC sits

The same service costs 3.2 times more in Hawaii than in New Jersey. 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.

Washington, DC· 46th of 51

$52.48

HI $148NJ $45.71

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.