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Kansas 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 $269 · 10th–90th $93–$3470%50%10th90th$269Professionalmedian $257 · 10th–90th $132–$3090%20%40%10th90th$257$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

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
$269.15 / $269.15 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $169.82 / $257.04
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $275.42 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $371.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $239.88 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $173.78 / $1,995.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $281.84 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $234.42