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

Missouri 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?

$83.18

Typical negotiated rate. In Missouri, July 2026.

Insurers have agreed to pay about $83.18 for this service. The price depends on where it is billed: about $81.28 from a physician practice, and about $132 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 6 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$81.28$39.81 to $112
FacilityA hospital or hospital-owned outpatient department$132$91.20 to $135

How much rates vary

Facilitymedian $132 · 10th to 90th $79 to $257Professionalmedian $81 · 10th to 90th $39 to $209
$50$100$200$500facility $132professional $81

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
$79.43
Median
$79.43
Typical High
$91.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$83.18
Typical High
$257.04
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$467.74
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$38.90
Typical High
$199.53
BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$134.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$77.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$52.48
Medica
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$125.89
Typical High
$575.44
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$891.25
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$109.65
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$158.49

Where Missouri 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.

Missouri· 21st of 51

$83.18

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.