go back

Elastic Rib Gusset for TLSO (Low Profile)

New York 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?

$60.26

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $60.26 for this service. The price depends on where it is billed: about $60.26 from a physician practice, and about $66.07 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 9 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$60.26$56.23 to $75.86
FacilityA hospital or hospital-owned outpatient department$66.07$54.95 to $110

How much rates vary

Facilitymedian $66 · 10th to 90th $46 to $158Professionalmedian $60 · 10th to 90th $46 to $148
$100$1K$10Kfacility $66professional $60

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
$35.48
Median
$56.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$52.48
Typical High
$72.44
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$213.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$60.26
Typical High
$158.49
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$87.10
Typical High
$87.10
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$77.62
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$173.78
Typical High
$407.38
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$112.20
Typical High
$204.17
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$58.88
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$63.10
Typical High
$66.07
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$102.33
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$56.23
Typical High
$173.78
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$69.18
Typical High
$181.97
Univera
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$63.10
Typical High
$64.57
Univera
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$63.10
Typical High
$66.07

Where New York 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.

New York· 22nd of 51

$60.26

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.