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Delaware 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
Professional
Modifier
Low / Median / High Price
$33.11 / $39.81 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $48.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.08 / $51.29 / $54.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $54.95 / $79.43