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Elastic Rib Gusset for TLSO (Low Profile)

South Dakota 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?

$89.13

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $89.13 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 7 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$89.13$66.07 to $123
FacilityA hospital or hospital-owned outpatient department$95.50$74.13 to $112

How much rates vary

Facilitymedian $95 · 10th to 90th $66 to $132Professionalmedian $89 · 10th to 90th $62 to $151
$50.0$100.0$200.0$500.0facility $95professional $89

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. 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
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$66.07
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$151.36
Medica
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$97.72
Typical High
$181.97
Medica
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$69.18
Typical High
$676.08
Midlands
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$107.15
Midlands
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Midlands
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$173.78
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$97.72
Typical High
$128.82
United
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$56.23
Typical High
$81.28
United
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$74.13
Typical High
$123.03
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$97.72

Where South Dakota sits

The same service costs 3.7 times more in Hawaii than in Nebraska. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $89.13 · 7th of 51
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.