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Lumbar Derotation Pad for TLSO (Low Profile)

Kentucky 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?

$53.70

Typical negotiated rate. In Kentucky, October 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 $63.10 from a hospital or other facility.

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.

Prices by location type

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$63.10$58.88 to $102

How much rates vary

Facilitymedian $63 · 10th to 90th $56 to $151Professionalmedian $54 · 10th to 90th $46 to $87
$50$100$200$500facility $63professional $54

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$31.62
Median
$58.88
Typical High
$61.66
Aetna
Setting
Professional
Modifier
None
Typical Low
$31.62
Median
$58.88
Typical High
$77.62
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$69.18
Median
$112.20
Typical High
$117.49
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$52.48
Typical High
$74.13
CareSource
Setting
Facility
Modifier
None
Typical Low
$72.44
Median
$100.00
Typical High
$158.49
CareSource
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$138.04
Typical High
$177.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$151.36
Cigna
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$63.10
Typical High
$489.78
Molina
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$85.11
United
Setting
Facility
Modifier
None
Typical Low
$56.23
Median
$56.23
Typical High
$58.88
United
Setting
Professional
Modifier
None
Typical Low
$33.88
Median
$50.12
Typical High
$72.44
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$20.89
Median
$29.51
Typical High
$38.90
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$8.32
Median
$11.75
Typical High
$15.49
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$6.17
Median
$8.91
Typical High
$11.48
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$4.17
Median
$5.89
Typical High
$7.76
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$5.25
Median
$5.25
Typical High
$5.25
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$39.81
Median
$39.81
Typical High
$39.81

Where Kentucky 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.

Kentucky· 33rd of 51

$53.70

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.