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Sacroiliac Orthosis, Flexible, Off-the-Shelf

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

Rates data updated October 2026.

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

$50.12

Typical negotiated rate. In Kentucky, October 2026.

Insurers have agreed to pay about $50.12 for this service. The price depends on where it is billed: about $50.12 from a physician practice, and about $74.13 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$50.12$35.48 to $63.10
FacilityA hospital or hospital-owned outpatient department$74.13$48.98 to $77.62

How much rates vary

Facilitymedian $74 · 10th to 90th $35 to $105Professionalmedian $50 · 10th to 90th $30 to $72
$50$100$200facility $74professional $50

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
$35.48
Median
$35.48
Typical High
$39.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$35.48
Typical High
$63.10
Ambetter
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$47.86
Median
$75.86
Typical High
$81.28
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$50.12
Typical High
$72.44
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$6.31
Median
$6.31
Typical High
$6.31
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$38.02
Median
$47.86
Typical High
$47.86
CareSource
Setting
Facility
Modifier
None
Typical Low
$48.98
Median
$67.61
Typical High
$107.15
CareSource
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$93.33
Typical High
$120.23
Cigna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$77.62
Typical High
$104.71
Cigna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$61.66
Typical High
$346.74
Molina
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$72.44
Typical High
$87.10
United
Setting
Professional
Modifier
None
Typical Low
$36.31
Median
$50.12
Typical High
$70.79

Where Kentucky 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.

Kentucky· 43rd of 51

$50.12

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.