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Lumbar Derotation Pad for TLSO (Low Profile)

Kansas rates for HCPCS L1240

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

Rates data updated July 2026.

Facilitymedian $71 · 10th–90th $28$950%50%10th90th$71Professionalmedian $85 · 10th–90th $45$850%50%10th$85$0.1$0.5$2.0$10.0$50.0$200.0

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

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$50.12
Typical High
$75.86
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
BCBS
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$77.62
Typical High
$81.28
BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$66.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$125.89
Medica
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$61.66
Typical High
$467.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$43.65
Typical High
$602.56
United
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$70.79
Typical High
$89.13
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$43.65
Typical High
$66.07