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Anterior ASIS Pad for TLSO (Low Profile)

Louisiana rates for HCPCS L1250

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

Rates data updated July 2026.

Facilitymedian $74 · 10th–90th $48$1620%20%10th90th$74Professionalmedian $51 · 10th–90th $41$680%20%40%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
$52.48
Median
$52.48
Typical High
$52.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$51.29
Typical High
$70.79
BCBS
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$134.90
Typical High
$190.55
BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Christus
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
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
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$74.13
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$42.66
Typical High
$60.26