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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

Facilitymedian $76 · 10th–90th $46–$2140%20%10th90th$76Professionalmedian $52 · 10th–90th $36–$1260%20%10th90th$52$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
$45.71 / $45.71 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $46.77 / $141.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $263.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $63.10 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $75.86
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
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $72.44 / $323.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $67.61 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $60.26 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $61.66 / $87.10