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Colorado rates for HCPCS L0622

Sacroiliac orthosis (SO), flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated

Facilitymedian $282 · 10th–90th $162–$3630%20%40%10th90th$282Professionalmedian $166 · 10th–90th $129–$2690%20%10th90th$166$0.2$1.0$5.0$20.0$100.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $281.84 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $162.18 / $257.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $331.13 / $645.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $177.83 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $309.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $295.12 / $478.63
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $295.12 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $144.54 / $295.12