go back

Alabama rates for HCPCS L0621

Sacroiliac orthosis (SO), flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.23 / $80.23 / $80.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.12 / $62.39 / $80.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.70 / $66.70 / $66.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.23 / $67.20 / $77.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.06 / $67.20 / $84.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.88 / $105.88 / $124.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.54 / $51.83 / $78.06