HCPCS L1240
Addition to tlso, (low profile), lumbar derotation pad
Current code24 hospitals with prices
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | $48.80 | $122 |
| Deaconess Medical Center | — | $48.80 | $122 |
| Harborview Medical Center | — | $117 | $167 |
| Mary Bridge Children's Hospital | — | $48.80 | $122 |
| MultiCare Auburn Medical Center | — | $48.80 | $122 |
| MultiCare Covington Medical Center | — | $48.80 | $122 |
| MultiCare Good Samaritan Hospital | — | $48.80 | $122 |
| MultiCare Valley Hospital | — | $48.80 | $122 |
| Seattle Children's Hospital | $48.53 – $61.38 | $189 | $189 |
| Tacoma General Allenmore Hospital | — | $48.80 | $122 |
| University of Washington Medical Ctr | — | $156 | $223 |
| Yakima Valley Memorial | — | $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)