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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Florida 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 October 2026.

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

$53.70

Typical negotiated rate. In Florida, October 2026.

Insurers have agreed to pay about $53.70 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $141 from a hospital or other facility.

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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$53.70$48.98 to $75.86
FacilityA hospital or hospital-owned outpatient department$141$72.44 to $174

How much rates vary

Facilitymedian $141 · 10th to 90th $68 to $174Professionalmedian $54 · 10th to 90th $45 to $78
$50$100facility $141professional $54

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$44.67
Median
$44.67
Typical High
$56.23
Aetna
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$47.86
Typical High
$56.23
Ambetter
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$177.83
AvMed
Setting
Facility
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
AvMed
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$75.86
Typical High
$83.18
Cigna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$77.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$67.61
Florida Blue
Setting
Facility
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$173.78
Florida Blue
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$75.86
Typical High
$75.86
Molina
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$77.62
Typical High
$85.11
United
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
United
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$53.70
Typical High
$67.61
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$77.62
Typical High
$77.62

Where Florida sits

The same service costs 3.6 times more in Hawaii than in Utah. 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.

Florida· 35th of 51

$53.70

HI $129UT $35.48

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.