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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Georgia 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?

$63.10

Typical negotiated rate. In Georgia, July 2026.

Insurers have agreed to pay about $63.10 for this service. The price depends on where it is billed: about $61.66 from a physician practice, and about $75.86 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 7 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$61.66$43.65 to $87.10
FacilityA hospital or hospital-owned outpatient department$75.86$43.65 to $126

How much rates vary

Facilitymedian $76 · 10th to 90th $44 to $282Professionalmedian $62 · 10th to 90th $39 to $107
$50$100$200facility $76professional $62

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$43.65
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$47.86
Typical High
$107.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$70.79
Typical High
$177.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$181.97
Typical High
$281.84
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$89.13
Typical High
$125.89
CareSource
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
CareSource
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$102.33
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$75.86
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$51.29
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$52.48
Typical High
$85.11

Where Georgia 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.

Georgia· 14th of 51

$63.10

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.