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Anterior ASIS Pad for TLSO (Low Profile)

Utah 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?

$48.98

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $50.12 from a physician practice, and about $40.74 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$50.12$37.15 to $83.18
FacilityA hospital or hospital-owned outpatient department$40.74$26.30 to $81.28

How much rates vary

Facilitymedian $41 · 10th to 90th $26 to $81Professionalmedian $50 · 10th to 90th $26 to $398
$50.0$100.0$200.0facility $41professional $50

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
Facility
Modifier
Global
Typical Low
$26.30
Median
$26.30
Typical High
$26.30
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$40.74
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$61.66
Molina
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$58.88
Typical High
$77.62
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$81.28
Typical High
$81.28
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$57.54
Typical High
$95.50
Select Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$83.18
Select Health
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$83.18
Typical High
$87.10
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$83.18
Typical High
$104.71
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$41.69
Typical High
$74.13
United
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$40.74
Typical High
$61.66

Where Utah 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.

Utah $48.98 · 33rd 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.