go back

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

Facilitymedian $76 · 10th–90th $43–$2820%20%10th90th$76Professionalmedian $58 · 10th–90th $38–$1070%10%20%10th90th$58$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $51.29 / $107.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $70.79 / $177.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $181.97 / $281.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $89.13 / $125.89
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $102.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $75.86 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $51.29 / $74.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $51.29 / $85.11