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Lumbar Derotation Pad for TLSO (Low Profile)

Massachusetts rates for HCPCS L1240

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

Rates data updated July 2026.

Facilitymedian $117 · 10th–90th $44$1860%20%10th90th$117Professionalmedian $83 · 10th–90th $42$1260%20%40%10th90th$83$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$41.69
Median
$41.69
Typical High
$41.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$45.71
Typical High
$131.83
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$97.72
Typical High
$562.34
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$74.13
Typical High
$114.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$123.03
Typical High
$165.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$63.10
Typical High
$66.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$69.18
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$125.89
Health New England
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Health New England
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$97.72
Typical High
$562.34
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$74.13
Typical High
$114.82
United
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$54.95
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$79.43
Typical High
$89.13