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Lumbar Derotation Pad for TLSO (Low Profile)

Wyoming rates for HCPCS L1240

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

Rates data updated July 2026.

Facilitymedian $49 · 10th–90th $44$850%20%10th90th$49Professionalmedian $49 · 10th–90th $46$850%20%40%10th90th$49$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$48.98
Typical High
$75.86
BCBS
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
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
United
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$70.79
United
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$43.65
Typical High
$66.07