go back

Lumbar Derotation Pad for TLSO (Low Profile)

Michigan rates for HCPCS L1240

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

Rates data updated July 2026.

How much does Lumbar Derotation Pad for TLSO (Low Profile) cost?

$63.10

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $63.10 for this service. The price depends on where it is billed: about $63.10 from a physician practice, and about $295 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$63.10$52.48 to $110
FacilityA hospital or hospital-owned outpatient department$295$120 to $347

How much rates vary

Facilitymedian $295 · 10th to 90th $63 to $363Professionalmedian $63 · 10th to 90th $46 to $110
$50$100$200$500facility $295professional $63

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$295.12
Typical High
$363.08
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$53.70
Typical High
$63.10
BCBS
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$331.13
Typical High
$630.96
BCBS
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$109.65
Typical High
$114.82
CareSource
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
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
$63.10
Typical High
$107.15
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$208.93
Typical High
$234.42
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$87.10
Typical High
$134.90
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$91.20
Typical High
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$89.13
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$51.29
Typical High
$74.13

Where Michigan sits

The same service costs 3.7 times more in Hawaii than in Washington, DC. 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.

Michigan· 14th of 51

$63.10

HI $148DC $39.81

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.