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Vermont 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 $68 · 10th–90th $51–$780%50%10th90th$68Professionalmedian $59 · 10th–90th $44–$710%20%10th90th$59$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $58.88 / $67.61
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $87.10
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $95.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $79.43 / $141.25