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Sacroiliac Orthosis, Flexible, Off-the-Shelf

Wyoming 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?

$47.86

Typical negotiated rate. In Wyoming, October 2026.

Insurers have agreed to pay about $47.86 for this service. Most negotiated rates run $47.86 to $51.29.

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.

How much rates vary

Facilitymedian $68 · 10th to 90th $63 to $68Professionalmedian $48 · 10th to 90th $48 to $63
$20$50facility $68professional $48

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Aetna
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$63.10
Typical High
$66.07
BCBS Wyoming
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$47.86
Typical High
$47.86
BCBS Wyoming
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$33.11
Median
$33.11
Typical High
$33.11
Cigna
Setting
Facility
Modifier
None
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Cigna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$67.61
United
Setting
Professional
Modifier
None
Typical Low
$19.05
Median
$51.29
Typical High
$57.54

Where Wyoming 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.

Wyoming· 50th of 51

$47.86

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.