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Delaware 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 $182 · 10th–90th $0–$1910%50%10th90th$182Professionalmedian $158 · 10th–90th $132–$7760%20%40%10th90th$158$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $158.49 / $776.25
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 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.23 / $144.54 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $169.82 / $257.04