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Oklahoma 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 $151 · 10th–90th $132–$4270%20%10th90th$151Professionalmedian $155 · 10th–90th $129–$2190%20%10th90th$155$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
$138.04 / $138.04 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $158.49 / $213.80
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 / $371.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $194.98 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $144.54 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $208.93