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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

Facilitymedian $141 · 10th–90th $52–$2140%10%20%10th90th$141Professionalmedian $62 · 10th–90th $36–$850%20%10th90th$62$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$52.48 / $75.86 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $52.48 / $79.43
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $83.18 / $331.13
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $72.44 / $109.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $158.49 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $77.62
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $100.00
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $83.18 / $331.13
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $72.44 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $61.66 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $64.57 / $85.11