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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Louisiana 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?

$64.57

Typical negotiated rate. In Louisiana, October 2026.

Insurers have agreed to pay about $64.57 for this service. The price depends on where it is billed: about $60.26 from a physician practice, and about $129 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$60.26$48.98 to $72.44
FacilityA hospital or hospital-owned outpatient department$129$95.50 to $186

How much rates vary

Facilitymedian $129 · 10th to 90th $68 to $229Professionalmedian $60 · 10th to 90th $44 to $72
$50$100$200facility $129professional $60

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
$60.26
Median
$60.26
Typical High
$64.57
Aetna
Setting
Professional
Modifier
None
Typical Low
$51.29
Median
$64.57
Typical High
$67.61
BCBS Louisiana
Setting
Facility
Modifier
None
Typical Low
$97.72
Median
$169.82
Typical High
$239.88
BCBS Louisiana
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Christus
Setting
Facility
Modifier
None
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$74.13
Cigna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$67.61
United
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$128.82
Typical High
$128.82
United
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$52.48
Typical High
$74.13

Where Louisiana 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.

Louisiana· 16th of 51

$64.57

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.