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Hawaii 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 $65 · 10th–90th $51–$1150%20%10th90th$65Professionalmedian $56 · 10th–90th $37–$1290%10%20%10th90th$56$20.0$50.0$100.0$200.0

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $51.29 / $63.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $77.62 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $117.49 / $158.49
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $134.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $52.48 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $79.43 / $138.04