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Idaho 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 $89 · 10th–90th $52–$1410%20%10th90th$89Professionalmedian $93 · 10th–90th $58–$1910%10%10th90th$93$50.0$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $75.86 / $114.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $281.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $190.55 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $52.48
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $89.13 / $141.25
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $107.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $147.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $112.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $123.03
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $89.13 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $109.65 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $95.50 / $158.49