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Anterior ASIS Pad for TLSO (Low Profile)

Alaska rates for HCPCS L1250

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

Rates data updated October 2026.

How much does Anterior ASIS Pad for TLSO (Low Profile) cost?

$100

Typical negotiated rate. In Alaska, October 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $87.10 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$100$81.28 to $100
FacilityA hospital or hospital-owned outpatient department$87.10$61.66 to $100

How much rates vary

Facilitymedian $87 · 10th to 90th $62 to $105Professionalmedian $100 · 10th to 90th $51 to $120
$50$100$200facility $87professional $100

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
Facility
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Aetna
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$87.10
Typical High
$87.10
Cigna
Setting
Facility
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$67.61
Cigna
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$44.67
Typical High
$120.23
Moda Health
Setting
Facility
Modifier
None
Typical Low
$26.30
Median
$100.00
Typical High
$125.89
Moda Health
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$100.00
Typical High
$104.71
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$104.71
Premera BCBS
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$100.00
Typical High
$102.33
Premera BCBS
Setting
Professional
Modifier
NR · New when rented
Typical Low
$85.11
Median
$100.00
Typical High
$100.00
Providence
Setting
Facility
Modifier
None
Typical Low
$26.30
Median
$61.66
Typical High
$125.89
Providence
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$61.66
Typical High
$120.23
United
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$60.26
Typical High
$223.87

Where Alaska sits

The same service costs 2.5 times more in Hawaii than in Arizona. 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.

Alaska· 2nd of 51

$100

HI $112AZ $44.67

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.