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New Jersey 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 $39 · 10th–90th $37–$780%50%10th90th$39Professionalmedian $49 · 10th–90th $33–$910%10%10th90th$49$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $41.69 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $67.61
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $70.79 / $97.72
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $91.20 / $91.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $54.95 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $54.95 / $83.18