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Elastic Rib Gusset for TLSO (Low Profile)

Montana rates for HCPCS L1280

Addition to thoracic-lumbar-sacral orthosis (TLSO), (low profile), rib gusset (elastic), each

Rates data updated July 2026.

How much does Elastic Rib Gusset for TLSO (Low Profile) cost?

$93.33

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $93.33 for this service. The price depends on where it is billed: about $77.62 from a physician practice, and about $95.50 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 5 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$77.62$51.29 to $95.50
FacilityA hospital or hospital-owned outpatient department$95.50$81.28 to $102

How much rates vary

Facilitymedian $95 · 10th to 90th $72 to $117Professionalmedian $78 · 10th to 90th $32 to $186
$50$100$200$500facility $95professional $78

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
Professional
Modifier
Global
Typical Low
$31.62
Median
$54.95
Typical High
$562.34
Cigna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$102.33
Typical High
$102.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$102.33
Typical High
$102.33
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$186.21
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$95.50
Typical High
$186.21
Providence
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$91.20
Typical High
$131.83
Providence
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$79.43
Typical High
$102.33
United
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$54.95
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$48.98
Typical High
$74.13

Where Montana sits

The same service costs 3.7 times more in Hawaii than in Nebraska. 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.

Montana· 5th of 51

$93.33

HI $166NE $44.67

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.