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Anterior ASIS Pad for TLSO (Low Profile)

Montana rates for HCPCS L1250

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

Rates data updated July 2026.

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

$79.43

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $79.43 for this service. The price depends on where it is billed: about $69.18 from a physician practice, and about $79.43 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$69.18$40.74 to $85.11
FacilityA hospital or hospital-owned outpatient department$79.43$67.61 to $85.11

How much rates vary

Facilitymedian $79 · 10th to 90th $58 to $100Professionalmedian $69 · 10th to 90th $32 to $155
$50.0$100.0$200.0facility $79professional $69

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$50.12
Typical High
$398.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$85.11
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$85.11
Typical High
$85.11
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$79.43
Typical High
$154.88
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$79.43
Typical High
$154.88
Providence
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$75.86
Typical High
$107.15
Providence
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$79.43
Typical High
$85.11
United
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$45.71
Typical High
$51.29
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$40.74
Typical High
$61.66

Where Montana sits

The same service costs 2.8 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Montana $79.43 · 7th of 51
HI $112DC $39.81

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.