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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Mississippi 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 October 2026.

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

$67.61

Typical negotiated rate. In Mississippi, October 2026.

Insurers have agreed to pay about $67.61 for this service. The price depends on where it is billed: about $53.70 from a physician practice, and about $81.28 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$53.70$48.98 to $70.79
FacilityA hospital or hospital-owned outpatient department$81.28$81.28 to $81.28

How much rates vary

Facilitymedian $81 · 10th to 90th $68 to $81Professionalmedian $54 · 10th to 90th $44 to $71
$50$100facility $81professional $54

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$43.65
Median
$43.65
Typical High
$67.61
Aetna
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$51.29
Typical High
$67.61
BCBS Mississippi
Setting
Facility
Modifier
None
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
BCBS Mississippi
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Cigna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$77.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$67.61
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$61.66
United
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$128.82
Typical High
$151.36
United
Setting
Professional
Modifier
None
Typical Low
$36.31
Median
$51.29
Typical High
$72.44

Where Mississippi sits

The same service costs 3.6 times more in Hawaii than in Utah. 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.

Mississippi· 14th of 51

$67.61

HI $129UT $35.48

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.