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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

Facilitymedian $56 · 10th–90th $33–$1070%10%10th90th$56Professionalmedian $42 · 10th–90th $28–$780%10%20%10th90th$42$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $41.69 / $64.57
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $56.23 / $77.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $89.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $154.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $56.23 / $100.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $67.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $56.23 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $51.29 / $77.62