HCPCS L1240
Addition to tlso, (low profile), lumbar derotation pad
Current code24 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $97.60 – $104 | $48.80 | $122 |
| Deaconess Medical Center | $86.62 – $89.06 | $48.80 | $122 |
| Harborview Medical Center | — | $117 | $167 |
| Mary Bridge Children's Hospital | $79.79 – $97.60 | $48.80 | $122 |
| MultiCare Auburn Medical Center | $71.98 – $89.06 | $48.80 | $122 |
| MultiCare Covington Medical Center | $71.98 – $89.06 | $48.80 | $122 |
| MultiCare Good Samaritan Hospital | $71.98 – $89.06 | $48.80 | $122 |
| MultiCare Valley Hospital | $87.84 | $48.80 | $122 |
| Seattle Children's Hospital | $102 – $181 | $189 | $189 |
| Tacoma General Allenmore Hospital | $71.98 – $89.06 | $48.80 | $122 |
| University of Washington Medical Ctr | — | $156 | $223 |
| Yakima Valley Memorial | $68.32 | $48.80 | $122 |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Equipment fee, Washington
- $95.36 (fee)