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Sacroiliac Orthosis, Rigid or Semi-Rigid, Off-the-Shelf

Connecticut 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

Rates data updated October 2026.

How much does Sacroiliac Orthosis, Rigid or Semi-Rigid, Off-the-Shelf cost?

$52.48

Typical negotiated rate. In Connecticut, October 2026.

Insurers have agreed to pay about $52.48 for this service. The price depends on where it is billed: about $41.69 from a physician practice, and about $107 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$41.69$38.90 to $87.10
FacilityA hospital or hospital-owned outpatient department$107$52.48 to $138

How much rates vary

Facilitymedian $107 · 10th to 90th $52 to $148Professionalmedian $42 · 10th to 90th $39 to $135
$50$100$200facility $107professional $42

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$138.04
Typical High
$165.96
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$38.90
Typical High
$41.69
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$29.51
Median
$29.51
Typical High
$29.51
Cigna
Setting
Facility
Modifier
None
Typical Low
$52.48
Median
$52.48
Typical High
$54.95
Cigna
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$38.02
Typical High
$52.48
ConnectiCare
Setting
Facility
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
ConnectiCare
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$93.33
Typical High
$138.04
Health New England
Setting
Professional
Modifier
None
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
United
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$104.71
Typical High
$147.91

Where Connecticut sits

The same service costs 5.4 times more in Hawaii than in New Hampshire. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Connecticut· 50th of 51

$52.48

HI $214NH $39.81

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.