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Anterior ASIS Pad for TLSO (Low Profile)

Nevada rates for HCPCS L1250

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

Rates data updated July 2026.

Facilitymedian $32 · 10th–90th $32$930%50%90th$32Professionalmedian $45 · 10th–90th $32$1320%10%20%10th90th$45$1.0$5.0$20.0$100.0

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
$31.62
Median
$31.62
Typical High
$31.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$39.81
Typical High
$398.11
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$51.29
Cigna
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$61.66
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$44.67
Typical High
$66.07
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$93.33
Typical High
$162.18
Select Health
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
Select Health
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$85.11
Typical High
$93.33
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$39.81
Typical High
$51.29
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$58.88
Typical High
$104.71