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Lumbar Derotation Pad for TLSO (Low Profile)

Indiana 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?

$53.70

Typical negotiated rate. In Indiana, July 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $112 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$53.70$51.29 to $58.88
FacilityA hospital or hospital-owned outpatient department$112$53.70 to $112

How much rates vary

Facilitymedian $112 · 10th to 90th $52 to $117Professionalmedian $54 · 10th to 90th $46 to $81
$50$100$200facility $112professional $54

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
Facility
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
Aetna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$53.70
Typical High
$72.44
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$112.20
Typical High
$141.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$53.70
Typical High
$100.00
CareSource
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$144.54
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$95.50
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$58.88
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$52.48
Typical High
$77.62

Where Indiana 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.

Indiana· 30th of 51

$53.70

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.