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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Oklahoma 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?

$67.61

Typical negotiated rate. In Oklahoma, October 2026.

Insurers have agreed to pay about $67.61 for this service. The price depends on where it is billed: about $64.57 from a physician practice, and about $69.18 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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$64.57$48.98 to $75.86
FacilityA hospital or hospital-owned outpatient department$69.18$67.61 to $105

How much rates vary

Facilitymedian $69 · 10th to 90th $43 to $324Professionalmedian $65 · 10th to 90th $41 to $110
$50$100$200$500facility $69professional $65

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
$40.74
Median
$40.74
Typical High
$40.74
Aetna
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$39.81
Typical High
$40.74
BCBS Oklahoma
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
BCBS Oklahoma
Setting
Professional
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
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
$48.98
Medica
Setting
Facility
Modifier
None
Typical Low
$44.67
Median
$69.18
Typical High
$323.59
Medica
Setting
Professional
Modifier
None
Typical Low
$43.65
Median
$70.79
Typical High
$524.81
United
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
United
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$51.29
Typical High
$74.13

Where Oklahoma 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.

Oklahoma· 15th of 51

$67.61

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.