HCPCS L1240
Addition to tlso, (low profile), lumbar derotation pad
Current code24 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $93.45 – $103 | $48.80 | $122 |
| Deaconess Medical Center | $93.45 – $103 | $48.80 | $122 |
| Harborview Medical Center | $95.36 – $105 | $117 | $167 |
| Kadlec Regional Medical Center | $95.36 – $114 | — | — |
| Mary Bridge Children's Hospital | $93.45 – $103 | $48.80 | $122 |
| MultiCare Auburn Medical Center | $93.45 – $103 | $48.80 | $122 |
| MultiCare Covington Medical Center | $93.45 – $103 | $48.80 | $122 |
| MultiCare Good Samaritan Hospital | $93.45 – $103 | $48.80 | $122 |
| MultiCare Valley Hospital | $96.26 – $103 | $48.80 | $122 |
| Overlake Hospital Medical Center & Clinics | $95.36 – $99.17 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $95.36 – $114 | — | — |
| Providence Centralia Hospital | $95.36 – $153 | — | — |
| Providence Regional Medical Center Everett | $95.36 – $105 | — | — |
| Providence St Peter Hospital | $95.36 – $153 | — | — |
| Seattle Children's Hospital | — | $189 | $189 |
| Swedish Edmonds Hospital | $95.36 – $114 | — | — |
| Swedish Issaquah | $95.36 – $114 | — | — |
| Swedish Medical Center | $95.36 – $114 | — | — |
| Swedish Medical Center / Cherry Hill | $95.36 – $114 | — | — |
| Tacoma General Allenmore Hospital | $93.45 – $103 | $48.80 | $122 |
| University of Washington Medical Ctr | $95.36 – $105 | $156 | $223 |
| Virginia Mason Medical Center | $65.44 – $98.16 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $93.45 – $105 | $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)