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West Virginia 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 $45 · 10th–90th $45–$1120%50%90th$45Professionalmedian $41 · 10th–90th $31–$740%10%20%10th90th$41$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
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $63.10
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $100.00
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $51.29 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $54.95 / $87.10