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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

Facilitymedian $49 · 10th–90th $33$1070%20%10th90th$49Professionalmedian $49 · 10th–90th $33$1020%10%10th90th$49$20.0$100.0$500.0$2.0K

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
$37.15 / $37.15 / $37.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $46.77 / $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 / $48.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $72.44 / $87.10
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $102.33 / $112.20
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $81.28 / $109.65
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $48.98 / $107.15
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $34.67 / $102.33
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $56.23 / $134.90
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $53.70 / $107.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $114.82 / $223.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $37.15 / $56.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $57.54 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $51.29 / $79.43