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 | $82.17 – $638 | $48.80 | $122 |
| Deaconess Medical Center | $45.32 – $397 | $48.80 | $122 |
| Harborview Medical Center | $153 – $191 | $117 | $167 |
| Kadlec Regional Medical Center | $144 – $268 | — | — |
| Mary Bridge Children's Hospital | $78.80 – $700 | $48.80 | $122 |
| MultiCare Auburn Medical Center | $79.89 – $412 | $48.80 | $122 |
| MultiCare Covington Medical Center | $79.89 – $412 | $48.80 | $122 |
| MultiCare Good Samaritan Hospital | $79.89 – $412 | $48.80 | $122 |
| MultiCare Valley Hospital | $45.32 – $396 | $48.80 | $122 |
| Overlake Hospital Medical Center & Clinics | $87.46 – $262 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $148 – $316 | — | — |
| Providence Centralia Hospital | $161 – $357 | — | — |
| Providence Regional Medical Center Everett | $114 – $221 | — | — |
| Providence St Peter Hospital | $81.06 – $311 | — | — |
| Seattle Children's Hospital | $102 – $181 | $189 | $189 |
| Swedish Edmonds Hospital | $143 – $350 | — | — |
| Swedish Issaquah | $143 – $212 | — | — |
| Swedish Medical Center | $143 – $341 | — | — |
| Swedish Medical Center / Cherry Hill | $143 – $341 | — | — |
| Tacoma General Allenmore Hospital | $79.89 – $412 | $48.80 | $122 |
| University of Washington Medical Ctr | $153 – $299 | $156 | $223 |
| Virginia Mason Medical Center | $91.30 – $332 | — | — |
| Wellfound Behavioral Health Hospital | $241 | — | — |
| Yakima Valley Memorial | $59.78 – $247 | $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)