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New Jersey 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 $110 · 10th–90th $100–$2950%50%10th90th$110Professionalmedian $162 · 10th–90th $112–$2880%10%10th90th$162$100.0$200.0$500.0$1.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $154.88 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $181.97
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $275.42 / $398.11
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $162.18 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $162.18 / $281.84