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Lumbar Derotation Pad for TLSO (Low Profile)

New Mexico rates for HCPCS L1240

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

Rates data updated July 2026.

Facilitymedian $65 · 10th–90th $28$1070%10%10th90th$65Professionalmedian $56 · 10th–90th $46$1170%10%20%10th90th$56$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
Facility
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$46.77
Aetna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$52.48
Typical High
$501.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$75.86
Typical High
$89.13
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
$162.18
Molina
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$138.04
Typical High
$208.93
Providence
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$67.61
Typical High
$107.15
Providence
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$97.72
United
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$48.98
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$43.65
Typical High
$66.07