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Anterior ASIS Pad for TLSO (Low Profile)

Delaware rates for HCPCS L1250

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

Rates data updated July 2026.

Facilitymedian $46 · 10th–90th $0$620%20%40%10th90th$46Professionalmedian $45 · 10th–90th $40$3550%50%10th90th$45$0.1$0.5$2.0$10.0$50.0$200.0

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
$39.81
Median
$39.81
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$61.66
United
Setting
Facility
Modifier
Global
Typical Low
$0.06
Median
$41.69
Typical High
$45.71
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$48.98
Typical High
$74.13