go back

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

Maryland 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?

$77.62

Typical negotiated rate. In Maryland, October 2026.

Insurers have agreed to pay about $77.62 for this service. Most negotiated rates run $52.48 to $102.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $52 · 10th to 90th $52 to $52Professionalmedian $78 · 10th to 90th $38 to $129
$50$100$200facility $52professional $78

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
$57.54
Median
$57.54
Typical High
$72.44
CareFirst
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$77.62
Typical High
$81.28
Cigna
Setting
Facility
Modifier
None
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$38.02
Typical High
$52.48
Johns Hopkins Employer Health Plan
Setting
Professional
Modifier
None
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$125.89
Typical High
$194.98
United
Setting
Professional
Modifier
None
Typical Low
$93.33
Median
$107.15
Typical High
$165.96
Wellpoint
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$38.90
Typical High
$102.33

Where Maryland 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.

Maryland· 39th of 51

$77.62

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.