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Lumbar Derotation Pad for TLSO (Low Profile)

Hawaii 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?

$148

Typical negotiated rate. In Hawaii, July 2026.

Insurers have agreed to pay about $148 for this service. Most negotiated rates run $64.57 to $148.

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 $56 · 10th to 90th $44 to $115Professionalmedian $148 · 10th to 90th $30 to $155
$50$100$200facility $56professional $148

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$56.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$114.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$134.90
Typical High
$181.97
HMSA
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$154.88
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$147.91
Typical High
$208.93
United
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$48.98
Typical High
$56.23
United
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$72.44
Typical High
$181.97

Where Hawaii 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.

Hawaii· 1st of 51

$148

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.