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Florida 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 $141 · 10th–90th $126–$2290%50%10th90th$141Professionalmedian $158 · 10th–90th $126–$2570%20%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $134.90 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $162.18 / $257.04
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $281.84 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $181.97
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $177.83 / $302.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $208.93 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $151.36 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $208.93
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $302.00