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Washington, DC 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.97 / $57.97 / $57.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.97 / $57.97 / $57.97
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.52 / $78.52 / $79.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.08 / $38.08 / $38.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.15 / $76.15 / $231.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.20 / $103.82 / $128.62