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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

Facilitymedian $58 · 10th–90th $58$2570%50%90th$58Professionalmedian $71 · 10th–90th $58$1480%20%40%10th90th$71$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$70.79
Typical High
$147.91
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$81.28
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$53.70
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$102.33
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$104.71
Typical High
$141.25