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Anterior ASIS Pad for TLSO (Low Profile)

West Virginia rates for HCPCS L1250

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

Rates data updated July 2026.

Facilitymedian $50 · 10th–90th $46$1480%50%10th90th$50Professionalmedian $48 · 10th–90th $40$630%20%40%10th90th$48$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$47.86
Typical High
$50.12
CareSource
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$147.91
CareSource
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$457.09
United
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$41.69
Typical High
$93.33
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$54.95
Typical High
$81.28