Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated cost in Indiana
$964
Cash from
$964–$2,033
Cash range · 10 distinct prices
$727
Insurer rates from
12
Hospitals
Lowest published amounts at each hospital, from each hospital's own price file. Newest file: Mar 2026; each row shows its own date.
Prices by hospital
| Hospital | City | Cash | Insurer from | Data date |
|---|---|---|---|---|
| Indiana University Health Ball Memorial Hospital Inc. | Muncie | $964 | $727 | Mar 2026205 days old |
| Indiana University Health Arnett Inc. | Lafayette | $1,135 | $863 | Mar 2026205 days old |
| Indiana University Health Inc. | Indianapolis | $1,290 | $909 | Mar 2026205 days old |
| Indiana University Health North Hospital Inc. | Carmel | $1,290 | $909 | Mar 2026205 days old |
| Indiana University Health West Hospital Inc. | Avon | $1,290 | $909 | Mar 2026205 days old |
| Indiana University Health Bloomington Inc. | Bloomington | $1,118 | $954 | Mar 2026205 days old |
| Indiana University Health Bedford Inc. | Bedford | $1,297 | $1,817 | Mar 2026205 days old |
| Indiana University Health White Memorial Hospital Inc. | Monticello | $1,417 | $1,681 | Mar 2026205 days old |
| Indiana University Health Tipton Hospital Inc. | Tipton | $1,711 | $1,817 | Mar 2026205 days old |
| Indiana University Health Paoli Inc. | Paoli | $1,743 | $1,817 | Mar 2026205 days old |
| Indiana University Health Jay Inc. | Portland | $2,033 | $1,817 | Mar 2026205 days old |
| Indiana University Health Frankfort Inc. | Frankfort | $1,834 | $1,817 | Mar 2026205 days old |
Where this procedure name comes from
This is the HCPCS Level II descriptor published by CMS — a US government work in the public domain.
What the hospitals published for this code, in their own words:
- Beavercreek Medical CenterTLSO rigid plastic custom fa
- Berger HospitalTLSO rigid plastic custom fa
- Bethesda Hospital Inc.TLSO rigid plastic custom fa
- Clinton Memorial HospitalTLSO rigid plastic custom fa
- Dayton Osteopathic HospitalTLSO rigid plastic custom fa
- Fairview HospitalTlso rigid plastic custom fa
- Fort Hamilton HospitalTLSO rigid plastic custom fa
- Greene Memorial Hospital IncTLSO rigid plastic custom fa
- HEART HOSP OF AUSTINTlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapul
- HEART HOSP OF AUSTIN AT ST. DAVID'S ROUND ROCKTlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapul
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Price it for me →Estimates from published hospital rates — not your exact bill.