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Louisiana 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 $251 · 10th–90th $166–$5250%20%10th90th$251Professionalmedian $158 · 10th–90th $120–$2240%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
$165.96 / $165.96 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $162.18 / $229.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $436.52 / $602.56
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $39.81
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 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $239.88 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $208.93