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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 July 2026.

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

$45.71

Typical negotiated rate. In Tennessee, July 2026.

Insurers have agreed to pay about $45.71 for this service. The price depends on where it is billed: about $45.71 from a physician practice, and about $74.13 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 6 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$45.71$40.74 to $63.10
FacilityA hospital or hospital-owned outpatient department$74.13$51.29 to $331

How much rates vary

Facilitymedian $74 · 10th to 90th $46 to $331Professionalmedian $46 · 10th to 90th $40 to $74
$50$100$200$500facility $74professional $46

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
Facility
Modifier
Global
Typical Low
$41.69
Median
$45.71
Typical High
$72.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$43.65
Typical High
$72.44
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$83.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$67.61
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$331.13
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
United
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$57.54
Typical High
$77.62
United
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$51.29
Typical High
$72.44

Where Tennessee 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.

Tennessee· 43rd of 51

$45.71

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.