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Connecticut 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

Facilitymedian $59 · 10th–90th $59–$760%50%90th$59Professionalmedian $51 · 10th–90th $37–$790%10%10th90th$51$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $46.77 / $79.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $75.86 / $91.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $66.07 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
ConnectiCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $67.61
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $53.70 / $100.00
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $51.29 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $57.54 / $81.28