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Anterior ASIS Pad for TLSO (Low Profile)

Michigan 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?

$77.62

Typical negotiated rate. In Michigan, October 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $75.86 from a physician practice, and about $132 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$75.86$54.95 to $95.50
FacilityA hospital or hospital-owned outpatient department$132$61.66 to $275

How much rates vary

Facilitymedian $132 · 10th to 90th $62 to $417Professionalmedian $76 · 10th to 90th $45 to $98
$50$100$200$500$1Kfacility $132professional $76

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$54.95
Median
$95.50
Typical High
$95.50
Aetna
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$54.95
Typical High
$95.50
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$27.54
Median
$27.54
Typical High
$47.86
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$10.96
Median
$10.96
Typical High
$19.05
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$8.32
Median
$8.32
Typical High
$14.45
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$5.50
Median
$5.50
Typical High
$9.55
BCBS Michigan
Setting
Facility
Modifier
None
Typical Low
$114.82
Median
$281.84
Typical High
$537.03
BCBS Michigan
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$95.50
Typical High
$95.50
CareSource
Setting
Facility
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Cigna
Setting
Facility
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$61.66
Typical High
$100.00
Health Alliance Plan
Setting
Facility
Modifier
None
Typical Low
$54.95
Median
$186.21
Typical High
$204.17
Health Alliance Plan
Setting
Professional
Modifier
None
Typical Low
$54.95
Median
$75.86
Typical High
$97.72
Health Alliance Plan
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$26.92
Median
$26.92
Typical High
$26.92
Health Alliance Plan
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$10.96
Median
$10.96
Typical High
$10.96
Health Alliance Plan
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$8.13
Median
$8.13
Typical High
$8.13
Health Alliance Plan
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$5.50
Median
$5.50
Typical High
$5.50
Priority Health
Setting
Facility
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Priority Health
Setting
Professional
Modifier
None
Typical Low
$44.67
Median
$61.66
Typical High
$91.20
United
Setting
Facility
Modifier
None
Typical Low
$41.69
Median
$45.71
Typical High
$109.65
United
Setting
Professional
Modifier
None
Typical Low
$33.88
Median
$44.67
Typical High
$63.10

Where Michigan 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.

Michigan· 12th of 51

$77.62

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.