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Arkansas 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 $398,107 · 10th–90th $72–$933,2540%10%20%10th90th$398,107Professionalmedian $76 · 10th–90th $62–$1260%50%10th90th$76$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
$72.44 / $72.44 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $72.44 / $125.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $52.48
Qualchoice
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $181.97 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $158.49