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Indiana 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 $22–$910%20%40%10th90th$65Professionalmedian $47 · 10th–90th $35–$790%20%10th90th$47$0.1$0.5$2.0$10.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $37.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $40.74 / $77.62
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $72.44 / $97.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $64.57 / $109.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $63.10 / $102.33
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $97.72 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $67.61 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $52.48 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $51.29 / $75.86