go back

North Dakota 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 $214 · 10th–90th $209–$4790%20%40%10th90th$214Professionalmedian $224 · 10th–90th $138–$3550%10%20%10th90th$224$100.0$200.0$500.0$1.0K$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
$208.93 / $208.93 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $173.78 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $323.59 / $354.81
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
$181.97 / $371.54 / $467.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $288.40 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $144.54 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $194.98 / $380.19