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Illinois 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 $71 · 10th–90th $38$3240%10%20%10th90th$71Professionalmedian $48 · 10th–90th $37$790%20%10th90th$48$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
$38.02 / $54.95 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $43.65 / $72.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $51.29
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $257.04 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $47.86 / $47.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $85.11
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $141.25
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $67.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $52.48 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $87.10