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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Oregon 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 July 2026.

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

$48.98

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $51.29 from a physician practice, and about $48.98 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$51.29$37.15 to $66.07
FacilityA hospital or hospital-owned outpatient department$48.98$33.11 to $107

How much rates vary

Facilitymedian $49 · 10th to 90th $33 to $107Professionalmedian $51 · 10th to 90th $33 to $105
$50$100facility $49professional $51

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$56.23
Typical High
$66.07
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$72.44
Typical High
$87.10
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$102.33
Typical High
$117.49
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$100.00
Typical High
$107.15
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$48.98
Typical High
$107.15
Pacific Source
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$34.67
Typical High
$102.33
Providence
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$56.23
Typical High
$134.90
Providence
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$53.70
Typical High
$107.15
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$33.11
Median
$93.33
Typical High
$194.98
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$37.15
Typical High
$56.23
United
Setting
Facility
Modifier
Global
Typical Low
$0.08
Median
$51.29
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$51.29
Typical High
$79.43

Where Oregon sits

The same service costs 4.2 times more in Hawaii than in Washington, DC. 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.

Oregon· 38th of 51

$48.98

HI $129DC $30.90

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.