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Anterior ASIS Pad for TLSO (Low Profile)

South Dakota 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?

$74.13

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $74.13 for this service. The price depends on where it is billed: about $74.13 from a physician practice, and about $81.28 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 7 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$74.13$56.23 to $107
FacilityA hospital or hospital-owned outpatient department$81.28$69.18 to $93.33

How much rates vary

Facilitymedian $81 · 10th to 90th $56 to $112Professionalmedian $74 · 10th to 90th $51 to $138
$50$100$200$500facility $81professional $74

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. 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
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$58.88
Typical High
$74.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$91.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$138.04
Medica
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$83.18
Typical High
$151.36
Medica
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$58.88
Typical High
$457.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$89.13
Typical High
$89.13
Midlands
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20
Midlands
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$144.54
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$81.28
Typical High
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$47.86
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$61.66
Typical High
$112.20
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$81.28

Where South Dakota sits

The same service costs 2.8 times more in Hawaii than in Washington, DC. 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.

South Dakota· 9th of 51

$74.13

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.