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Sacroiliac Orthosis, Flexible, Off-the-Shelf

New Mexico 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 October 2026.

How much does Sacroiliac Orthosis, Flexible, Off-the-Shelf cost?

$56.23

Typical negotiated rate. In New Mexico, October 2026.

Insurers have agreed to pay about $56.23 for this service. The price depends on where it is billed: about $56.23 from a physician practice, and about $257 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$56.23$48.98 to $77.62
FacilityA hospital or hospital-owned outpatient department$257$67.61 to $562

How much rates vary

Facilitymedian $257 · 10th to 90th $33 to $776Professionalmedian $56 · 10th to 90th $42 to $102
$50$100$200$500$1Kfacility $257professional $56

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
Aetna
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$64.57
Typical High
$64.57
BCBS New Mexico
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$537.03
Typical High
$851.14
BCBS New Mexico
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$56.23
Typical High
$77.62
Cigna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Cigna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$67.61
Molina
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$102.33
Typical High
$154.88
Providence
Setting
Facility
Modifier
None
Typical Low
$33.11
Median
$67.61
Typical High
$87.10
Providence
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$67.61
United
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$128.82
United
Setting
Professional
Modifier
None
Typical Low
$46.77
Median
$51.29
Typical High
$77.62

Where New Mexico sits

The same service costs 3.6 times more in Hawaii than in Utah. 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.

New Mexico· 33rd of 51

$56.23

HI $129UT $35.48

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.