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Sacroiliac Orthosis, Flexible, Off-the-Shelf

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

Rates data updated October 2026.

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

$48.98

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $48.98 from a physician practice, and about $151 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$48.98$42.66 to $52.48
FacilityA hospital or hospital-owned outpatient department$151$77.62 to $316

How much rates vary

Facilitymedian $151 · 10th to 90th $65 to $575Professionalmedian $49 · 10th to 90th $38 to $83
$50$100$200$500$1Kfacility $151professional $49

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
$33.88
Median
$38.90
Typical High
$46.77
Aetna
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$38.02
Typical High
$63.10
Ambetter
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$51.29
Typical High
$51.29
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$87.10
Median
$218.78
Typical High
$616.60
BCBS Illinois
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$48.98
Typical High
$48.98
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
Hally Health
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$81.28
Typical High
$141.25
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
Molina
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$67.61
Typical High
$67.61
United
Setting
Facility
Modifier
None
Typical Low
$64.57
Median
$151.36
Typical High
$151.36
United
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$51.29
Typical High
$125.89

Where Illinois 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.

Illinois· 47th of 51

$48.98

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.