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Anterior ASIS Pad for TLSO (Low Profile)

South Carolina rates for HCPCS L1250

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

Rates data updated July 2026.

Facilitymedian $62 · 10th–90th $48$1350%20%10th90th$62Professionalmedian $54 · 10th–90th $37$950%20%10th90th$54$50.0$100.0$200.0$500.0

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
$53.70
Median
$53.70
Typical High
$53.70
Aetna
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$53.70
Typical High
$95.50
BCBS
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$100.00
Typical High
$109.65
BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$93.33
Typical High
$138.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$61.66
Typical High
$67.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$109.65
Medcost
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$58.88
Medcost
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$74.13
Typical High
$158.49
Medcost
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$26.30
United
Setting
Facility
Modifier
Global
Typical Low
$31.62
Median
$47.86
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$51.29
Typical High
$67.61