go back

Anterior ASIS Pad for TLSO (Low Profile)

Florida rates for HCPCS L1250

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

Rates data updated July 2026.

Facilitymedian $58 · 10th–90th $47$2040%20%10th90th$58Professionalmedian $51 · 10th–90th $43$950%20%10th90th$51$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$52.48
Typical High
$57.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$51.29
Typical High
$95.50
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$83.18
AvMed
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
AvMed
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$102.33
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$61.66
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$204.17
Typical High
$204.17
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$66.07
Typical High
$109.65
Molina
Setting
Professional
Modifier
Global
Typical Low
$20.89
Median
$32.36
Typical High
$37.15
United
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$47.86
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$51.29
Typical High
$61.66
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$109.65