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Lumbar Derotation Pad for TLSO (Low Profile)

Louisiana rates for HCPCS L1240

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

Rates data updated July 2026.

Facilitymedian $78 · 10th–90th $51$1700%20%10th90th$78Professionalmedian $52 · 10th–90th $43$720%20%40%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
$53.70
Median
$53.70
Typical High
$53.70
Aetna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$52.48
Typical High
$72.44
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$95.50
Typical High
$95.50
BCBS
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$141.25
Typical High
$194.98
BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$77.62
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$44.67
Typical High
$63.10