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Lumbar Derotation Pad for TLSO (Low Profile)

Maryland rates for HCPCS L1240

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

Rates data updated July 2026.

Facilitymedian $51 · 10th–90th $33$1000%10%10th90th$51Professionalmedian $46 · 10th–90th $40$830%20%10th90th$46$50.0$100.0$200.0$500.0

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
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$79.43
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$67.61
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
$63.10
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$100.00
Typical High
$147.91
United
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$43.65
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$50.12
Typical High
$77.62
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$85.11