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Alabama rates for HCPCS L0621

Sacroiliac Orthosis Flexible Provides Pelvic- Sacral Support Reduces Motion About The Sacro- Iliac Joint Includes Straps Closures May Include Pendulous Abdomen Design Prefabricated Off-The-Shelf (Revised 01/01/14)

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