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Montana 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 $68 · 10th–90th $48–$1450%20%10th90th$68Professionalmedian $51 · 10th–90th $27–$1000%10%10th90th$51$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $41.69 / $93.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $107.15 / $109.65
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $56.23 / $107.15
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $56.23 / $107.15
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $85.11 / $131.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $79.43 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $54.95 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $51.29 / $79.43