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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 July 2026.

Facilitymedian $59 · 10th–90th $40$1510%20%10th90th$59Professionalmedian $52 · 10th–90th $47$690%50%10th90th$52$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
$56.23
Median
$56.23
Typical High
$58.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$56.23
Typical High
$64.57
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$112.20
Typical High
$117.49
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$53.70
CareSource
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$147.91
Typical High
$194.98
CareSource
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$138.04
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$81.28
Typical High
$489.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$74.13
Typical High
$95.50
United
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$43.65
Typical High
$58.88
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$50.12
Typical High
$70.79