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Lumbar Derotation Pad for TLSO (Low Profile)

Utah 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?

$53.70

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $43.65 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$53.70$39.81 to $89.13
FacilityA hospital or hospital-owned outpatient department$43.65$28.18 to $87.10

How much rates vary

Facilitymedian $44 · 10th to 90th $28 to $87Professionalmedian $54 · 10th to 90th $28 to $501
$50$100$200$500facility $44professional $54

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
$28.18
Median
$28.18
Typical High
$28.18
Aetna
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$42.66
Typical High
$501.19
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
$63.10
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$64.57
Typical High
$83.18
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$87.10
Typical High
$87.10
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$63.10
Typical High
$104.71
Select Health
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Select Health
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$89.13
Typical High
$95.50
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$114.82
United
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$48.98
Typical High
$79.43
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$43.65
Typical High
$66.07

Where Utah 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.

Utah· 28th of 51

$53.70

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.