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Sacroiliac Orthosis, Flexible, Off-the-Shelf

North Carolina 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?

$70.79

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $70.79 for this service. The price depends on where it is billed: about $70.79 from a physician practice, and about $77.62 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$70.79$63.10 to $77.62
FacilityA hospital or hospital-owned outpatient department$77.62$63.10 to $105

How much rates vary

Facilitymedian $78 · 10th to 90th $43 to $204Professionalmedian $71 · 10th to 90th $40 to $78
$50$100$200facility $78professional $71

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
$77.62
Median
$77.62
Typical High
$77.62
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$77.62
Typical High
$77.62
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$63.10
BCBS
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$131.83
Typical High
$177.83
BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$74.13
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
$48.98
Typical High
$75.86
Medcost
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$56.23
Typical High
$69.18
Medcost
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$77.62
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$74.13
Typical High
$75.86
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$53.70
Typical High
$77.62
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03

Where North Carolina 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.

North Carolina· 6th of 51

$70.79

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.