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

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

Rates data updated October 2026.

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

$110

Typical negotiated rate. In Idaho, October 2026.

Insurers have agreed to pay about $110 for this service. The price depends on where it is billed: about $110 from a physician practice, and about $89.13 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 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$110$63.10 to $174
FacilityA hospital or hospital-owned outpatient department$89.13$85.11 to $112

How much rates vary

Facilitymedian $89 · 10th to 90th $52 to $1,202Professionalmedian $110 · 10th to 90th $38 to $191
$50$100$200$500$1K$2K$5Kfacility $89professional $110

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
$69.18
Median
$109.65
Typical High
$109.65
BCBS Idaho
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$112.20
Typical High
$281.84
BCBS Idaho
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$181.97
Typical High
$190.55
BCBS Idaho
Setting
Professional
Modifier
78 · Unplanned return to OR
Typical Low
$114.82
Median
$128.82
Typical High
$134.90
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
Moda Health
Setting
Facility
Modifier
None
Typical Low
$28.84
Median
$89.13
Typical High
$109.65
Moda Health
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$95.50
Typical High
$109.65
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$125.89
Typical High
$147.91
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$107.15
Median
$112.20
Typical High
$5,370.32
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$112.20
Typical High
$6,309.57
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$128.82
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$95.50
Select Health
Setting
Facility
Modifier
None
Typical Low
$89.13
Median
$89.13
Typical High
$91.20
Select Health
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$162.18
Typical High
$173.78
United
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$95.50
Typical High
$125.89

Where Idaho 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.

Idaho· 17th of 51

$110

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.