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Lumbar Derotation Pad for TLSO (Low Profile)

West Virginia rates for HCPCS L1240

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

Rates data updated October 2026.

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

$50.12

Typical negotiated rate. In West Virginia, October 2026.

Insurers have agreed to pay about $50.12 for this service. The price depends on where it is billed: about $50.12 from a physician practice, and about $63.10 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$50.12$45.71 to $66.07
FacilityA hospital or hospital-owned outpatient department$63.10$63.10 to $100

How much rates vary

Facilitymedian $63 · 10th to 90th $59 to $151Professionalmedian $50 · 10th to 90th $46 to $110
$50$100$200$500facility $63professional $50

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$50.12
Typical High
$50.12
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$25.12
Median
$25.12
Typical High
$25.12
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$10.00
Median
$10.00
Typical High
$10.00
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$7.59
Median
$7.59
Typical High
$7.59
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$5.01
Median
$5.01
Typical High
$5.01
CareSource
Setting
Facility
Modifier
None
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
CareSource
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$77.62
Typical High
$131.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$151.36
Cigna
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$45.71
Typical High
$489.78
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
United
Setting
Facility
Modifier
None
Typical Low
$56.23
Median
$58.88
Typical High
$100.00
United
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$54.95
Typical High
$109.65

Where West Virginia sits

The same service costs 3.2 times more in Hawaii than in Delaware. 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.

West Virginia· 47th of 51

$50.12

HI $148DE $45.71

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.