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Nationwide rates for HCPCS L0623

Sacroiliac orthosis (SO), provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf

Facilitymedian $74 · 10th–90th $32–$2190%20%10th90th$74Professionalmedian $79 · 10th–90th $50–$1740%20%40%10th90th$79$0.2$2.0$20.0$200.0$2.0K$20.0K$200.0K

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
$60.26 / $72.44 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $39.81 / $169.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $58.88 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $107.15 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $107.15 / $169.82

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