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North Carolina 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 $145 · 10th–90th $52$2450%20%10th90th$145Professionalmedian $123 · 10th–90th $69$1450%20%40%10th90th$123$0.2$1.0$5.0$20.0$100.0$500.0

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
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$85.11
Typical High
$144.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$229.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$141.25
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
$53.70
Medcost
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$144.54
Typical High
$186.21
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$0.60
Median
$0.60
Typical High
$0.60
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$100.00
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$107.15
Typical High
$158.49
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$602.56
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25