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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

Facilitymedian $93 · 10th–90th $56–$1380%20%40%10th90th$93Professionalmedian $63 · 10th–90th $39–$930%10%20%10th90th$63$20.0$50.0$100.0$200.0$500.0

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
$56.23 / $93.33 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $58.88 / $93.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $81.28 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $85.11 / $107.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $93.33 / $323.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $51.29 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $64.57 / $104.71