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Elastic Rib Gusset for TLSO (Low Profile)

South Carolina rates for HCPCS L1280

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

Rates data updated July 2026.

Facilitymedian $62 · 10th–90th $49$1350%20%10th90th$62Professionalmedian $52 · 10th–90th $46$870%20%10th90th$52$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Aetna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$51.29
Typical High
$87.10
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$102.33
BCBS
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$91.20
Typical High
$125.89
Cigna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$72.44
Typical High
$81.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$123.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$70.79
Medcost
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$83.18
Typical High
$177.83
Medcost
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$31.62
Molina
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
United
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$60.26
Typical High
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$48.98
Typical High
$69.18