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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Nevada 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?

$48.98

Typical negotiated rate. In Nevada, October 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $48.98 from a physician practice, and about $35.48 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$48.98$26.92 to $63.10
FacilityA hospital or hospital-owned outpatient department$35.48$33.88 to $46.77

How much rates vary

Facilitymedian $35 · 10th to 90th $25 to $74Professionalmedian $49 · 10th to 90th $21 to $79
$20$50$100$200$500$1K$2Kfacility $35professional $49

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$21.38
Median
$21.38
Typical High
$24.55
Aetna
Setting
Professional
Modifier
None
Typical Low
$21.38
Median
$21.38
Typical High
$44.67
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$33.88
Median
$34.67
Typical High
$46.77
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Cigna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$77.62
Cigna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$77.62
Hometown Health
Setting
Professional
Modifier
None
Typical Low
$25.12
Median
$33.88
Typical High
$81.28
Select Health
Setting
Facility
Modifier
None
Typical Low
$33.88
Median
$33.88
Typical High
$4,265.80
Select Health
Setting
Professional
Modifier
None
Typical Low
$22.91
Median
$30.20
Typical High
$109.65
United
Setting
Professional
Modifier
None
Typical Low
$25.12
Median
$51.29
Typical High
$81.28
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$47.86
Median
$47.86
Typical High
$47.86

Where Nevada 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.

Nevada· 48th of 51

$48.98

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.