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Kentucky 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 $60 · 10th–90th $43–$1120%20%10th90th$60Professionalmedian $44 · 10th–90th $30–$710%10%10th90th$44$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $43.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $43.65 / $66.07
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $81.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $75.86 / $81.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $63.10
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $100.00 / $131.83
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $93.33 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $74.13 / $331.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $75.86 / $97.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $51.29 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $51.29 / $75.86