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Maryland 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 $52 · 10th–90th $35–$710%10%20%10th90th$52Professionalmedian $48 · 10th–90th $31–$780%10%10th90th$48$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $43.65 / $77.62
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $57.54
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 / $67.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $67.61 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $51.29 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $51.29 / $81.28
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $61.66 / $61.66