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Sacroiliac Orthosis, Flexible, Off-the-Shelf

North Dakota 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?

$75.86

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $75.86 for this service. The price depends on where it is billed: about $69.18 from a physician practice, and about $93.33 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 5 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$69.18$63.10 to $83.18
FacilityA hospital or hospital-owned outpatient department$93.33$56.23 to $93.33

How much rates vary

Facilitymedian $93 · 10th to 90th $56 to $132Professionalmedian $69 · 10th to 90th $56 to $93
$50$100$200facility $93professional $69

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
$56.23
Median
$93.33
Typical High
$93.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$63.10
Typical High
$125.89
BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$85.11
Typical High
$107.15
Medica
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$93.33
Typical High
$323.59
Medica
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$51.29
Typical High
$104.71
United
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$51.29
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$72.44
Typical High
$104.71

Where North Dakota 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 Dakota· 4th of 51

$75.86

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.