go back

Sacroiliac Orthosis, Flexible, Off-the-Shelf

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

Rates data updated July 2026.

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

$63.10

Typical negotiated rate. In Michigan, July 2026.

Insurers have agreed to pay about $63.10 for this service. The price depends on where it is billed: about $63.10 from a physician practice, and about $102 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 7 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$63.10$42.66 to $63.10
FacilityA hospital or hospital-owned outpatient department$102$51.29 to $191

How much rates vary

Facilitymedian $102 · 10th to 90th $43 to $257Professionalmedian $63 · 10th to 90th $37 to $76
$1$5$20$100$500facility $102professional $63

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
$42.66
Median
$42.66
Typical High
$42.66
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$42.66
Typical High
$63.10
BCBS
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$190.55
Typical High
$363.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$66.07
CareSource
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
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
$67.61
Typical High
$117.49
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$199.53
Typical High
$218.78
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$75.86
Typical High
$100.00
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$87.10
Typical High
$128.82
United
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$64.57
Typical High
$128.82
United
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$50.12
Typical High
$79.43

Where Michigan 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.

Michigan· 20th of 51

$63.10

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.