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Anterior ASIS Pad for TLSO (Low Profile)

North Dakota 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 North Dakota, October 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $58.88 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$77.62$58.88 to $91.20
FacilityA hospital or hospital-owned outpatient department$58.88$58.88 to $66.07

How much rates vary

Facilitymedian $59 · 10th to 90th $59 to $178Professionalmedian $78 · 10th to 90th $41 to $100
$50$100$200facility $59professional $78

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Aetna
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$58.88
Typical High
$66.07
BCBS North Dakota
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$91.20
Typical High
$91.20
BCBS North Dakota
Setting
Professional
Modifier
22 · Increased work
Typical Low
$83.18
Median
$109.65
Typical High
$109.65
Cigna
Setting
Facility
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$109.65
Typical High
$138.04
Medica
Setting
Facility
Modifier
None
Typical Low
$42.66
Median
$58.88
Typical High
$436.52
Medica
Setting
Professional
Modifier
None
Typical Low
$32.36
Median
$44.67
Typical High
$67.61
United
Setting
Professional
Modifier
None
Typical Low
$31.62
Median
$44.67
Typical High
$67.61

Where North Dakota 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.

North Dakota· 13th 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.