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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Massachusetts 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 July 2026.

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

$64.57

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $64.57 for this service. The price depends on where it is billed: about $64.57 from a physician practice, and about $148 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$64.57$53.70 to $66.07
FacilityA hospital or hospital-owned outpatient department$148$105 to $178

How much rates vary

Facilitymedian $148 · 10th to 90th $54 to $234Professionalmedian $65 · 10th to 90th $43 to $100
$50$100$200$500$1K$2K$5Kfacility $148professional $65

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$120.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$53.70
Typical High
$125.89
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$83.18
Typical High
$331.13
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$72.44
Typical High
$109.65
BCBS
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$158.49
Typical High
$208.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$77.62
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$100.00
Health New England
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Health New England
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$83.18
Typical High
$331.13
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$72.44
Typical High
$109.65
United
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$64.57
Typical High
$128.82
United
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$64.57
Typical High
$85.11

Where Massachusetts sits

The same service costs 4.2 times more in Hawaii than in Washington, DC. 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.

Massachusetts· 9th of 51

$64.57

HI $129DC $30.90

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.