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Michigan 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 $95 · 10th–90th $42–$2570%10%20%10th90th$95Professionalmedian $51 · 10th–90th $36–$760%20%10th90th$51$0.1$0.5$2.0$10.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $44.67 / $69.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $190.55 / $363.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $66.07
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
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 / $67.61 / $117.49
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $199.53 / $218.78
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $75.86 / $100.00
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $77.62
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $77.62 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $58.88 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $50.12 / $75.86