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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Washington, DC 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?

$30.90

Typical negotiated rate. In Washington, DC, July 2026.

Insurers have agreed to pay about $30.90 for this service. The price depends on where it is billed: about $30.90 from a physician practice, and about $30.90 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 5 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$30.90$30.90 to $57.54
FacilityA hospital or hospital-owned outpatient department$30.90$30.90 to $30.90

How much rates vary

Facilitymedian $31 · 10th to 90th $31 to $151Professionalmedian $31 · 10th to 90th $31 to $59
$50$100facility $31professional $31

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$30.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$58.88
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$72.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$57.54
Typical High
$147.91
United
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$51.29
Typical High
$70.79

Where Washington, DC 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.

Washington, DC· 51st of 51

$30.90

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.