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

Massachusetts 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 July 2026.

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

$117

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $117 for this service. The price depends on where it is billed: about $117 from a physician practice, and about $117 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$117$72.44 to $117
FacilityA hospital or hospital-owned outpatient department$117$72.44 to $158

How much rates vary

Facilitymedian $117 · 10th to 90th $72 to $603Professionalmedian $117 · 10th to 90th $72 to $170
$1$10$100$1K$10Kfacility $117professional $117

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$144.54
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$147.91
Typical High
$602.56
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$128.82
Typical High
$190.55
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
$151.36
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$177.83
Health New England
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$147.91
Typical High
$602.56
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$128.82
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$125.89
Typical High
$213.80
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$117.49
Typical High
$165.96

Where Massachusetts sits

The same service costs 3.9 times more in Hawaii than in California. 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.

Massachusetts· 7th of 51

$117

HI $204CA $52.48

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.