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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Colorado 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

Rates data updated July 2026.

How much does Sacroiliac Orthosis, Flexible, Off-the-Shelf cost?

$47.86

Typical negotiated rate. In Colorado, July 2026.

Insurers have agreed to pay about $47.86 for this service. The price depends on where it is billed: about $47.86 from a physician practice, and about $50.12 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$47.86$33.11 to $58.88
FacilityA hospital or hospital-owned outpatient department$50.12$33.11 to $81.28

How much rates vary

Facilitymedian $50 · 10th to 90th $28 to $126Professionalmedian $48 · 10th to 90th $28 to $66
$50$100$200facility $50professional $48

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$27.54
Typical High
$47.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$38.90
Typical High
$63.10
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$60.26
Typical High
$107.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$63.10
Typical High
$64.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$77.62
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$56.23
Typical High
$134.90
Denver HMP
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$50.12
Typical High
$173.78
Select Health
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$93.33
Typical High
$104.71
Select Health
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$63.10
Typical High
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$51.29
Typical High
$64.57
United
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$51.29
Typical High
$77.62

Where Colorado sits

The same service costs 4.2 times more in Hawaii than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Colorado· 42nd of 51

$47.86

HI $129DC $30.90

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.