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North Dakota 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 $155 · 10th–90th $105–$2340%20%10th90th$155Professionalmedian $110 · 10th–90th $71–$1580%20%10th90th$110$50.0$100.0$200.0$500.0$1.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $154.88 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $83.18 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $144.54 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $151.36 / $190.55
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $158.49 / $467.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $107.15 / $234.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $134.90 / $181.97