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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Missouri 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 Missouri, 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 $75.86 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 6 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$48.98 to $75.86
FacilityA hospital or hospital-owned outpatient department$75.86$53.70 to $79.43

How much rates vary

Facilitymedian $76 · 10th to 90th $47 to $162Professionalmedian $63 · 10th to 90th $44 to $141
$50$100$200facility $76professional $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
$46.77
Median
$46.77
Typical High
$53.70
Aetna
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$50.12
Typical High
$141.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$263.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$63.10
Typical High
$125.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$67.61
Medica
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$72.44
Typical High
$323.59
Medica
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$67.61
Typical High
$524.81
United
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$60.26
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$61.66
Typical High
$87.10

Where Missouri 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.

Missouri· 18th 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.