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Elastic Rib Gusset for TLSO (Low Profile)

New Jersey rates for HCPCS L1280

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

Rates data updated October 2026.

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

$53.70

Typical negotiated rate. In New Jersey, October 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $72.44 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$53.70$44.67 to $107
FacilityA hospital or hospital-owned outpatient department$72.44$47.86 to $72.44

How much rates vary

Facilitymedian $72 · 10th to 90th $48 to $107Professionalmedian $54 · 10th to 90th $35 to $107
$50$100facility $72professional $54

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$35.48
Median
$35.48
Typical High
$40.74
Aetna
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$35.48
Typical High
$47.86
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$17.78
Median
$17.78
Typical High
$23.99
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$7.08
Median
$7.08
Typical High
$9.55
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$5.37
Median
$5.37
Typical High
$7.24
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$3.55
Median
$3.55
Typical High
$4.79
Cigna
Setting
Facility
Modifier
None
Typical Low
$72.44
Median
$72.44
Typical High
$107.15
Cigna
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$53.70
Typical High
$72.44
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$138.04
Typical High
$138.04
Horizon BCBS
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
United
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$64.57
Typical High
$112.20
United
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$56.23
Typical High
$102.33

Where New Jersey sits

The same service costs 3.2 times more in Hawaii than in Florida. 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.

New Jersey· 48th of 51

$53.70

HI $166FL $52.48

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.