go back

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

Facilitymedian $78 · 10th–90th $40–$2240%20%10th90th$78Professionalmedian $69 · 10th–90th $38–$780%20%40%10th90th$69$0.1$1.0$10.0$100.0$1.0K$10.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $61.66 / $77.62
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $107.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $75.86
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $56.23 / $69.18
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $77.62 / $141.25
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $51.29 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $53.70 / $77.62
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03