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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Rhode Island 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?

$60.26

Typical negotiated rate. In Rhode Island, July 2026.

Insurers have agreed to pay about $60.26 for this service. The price depends on where it is billed: about $58.88 from a physician practice, and about $170 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 4 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$58.88$53.70 to $72.44
FacilityA hospital or hospital-owned outpatient department$170$129 to $219

How much rates vary

Facilitymedian $170 · 10th to 90th $65 to $251Professionalmedian $59 · 10th to 90th $43 to $79
$50$100$200$500facility $170professional $59

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$58.88
Typical High
$72.44
BCBS
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$173.78
Typical High
$251.19
BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$114.82
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
United
Setting
Facility
Modifier
Global
Typical Low
$51.29
Median
$64.57
Typical High
$128.82
United
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$64.57
Typical High
$97.72

Where Rhode Island 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.

Rhode Island· 22nd of 51

$60.26

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.