go back

Sacroiliac Orthosis, Flexible, Off-the-Shelf

Tennessee 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?

$52.48

Typical negotiated rate. In Tennessee, October 2026.

Insurers have agreed to pay about $52.48 for this service. Most negotiated rates run $45.71 to $70.79.

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.

How much rates vary

Facilitymedian $68 · 10th to 90th $68 to $78Professionalmedian $51 · 10th to 90th $41 to $102
$50$100$200$500facility $68professional $51

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
$41.69
Median
$41.69
Typical High
$41.69
Aetna
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$41.69
Typical High
$63.10
Ambetter
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$70.79
Typical High
$70.79
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
$67.61
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
United
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$51.29
Typical High
$66.07

Where Tennessee 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.

Tennessee· 38th of 51

$52.48

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.