go back

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.09 / $31.09 / $31.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.09 / $31.09 / $31.09
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.99 / $57.99 / $57.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.06 / $49.06 / $49.06
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.48 / $42.48 / $128.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.47 / $149.47 / $149.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.54 / $51.83 / $77.87