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

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

Rates data updated July 2026.

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

$145

Typical negotiated rate. In North Dakota, July 2026.

Insurers have agreed to pay about $145 for this service. The price depends on where it is billed: about $145 from a physician practice, and about $158 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 5 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$145$107 to $158
FacilityA hospital or hospital-owned outpatient department$158$107 to $158

How much rates vary

Facilitymedian $158 · 10th to 90th $107 to $195Professionalmedian $145 · 10th to 90th $83 to $162
$50$100$200$500facility $158professional $145

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
$107.15
Median
$158.49
Typical High
$158.49
Aetna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$107.15
Typical High
$223.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$144.54
Typical High
$151.36
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$151.36
Typical High
$190.55
Medica
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$158.49
Typical High
$467.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$234.42
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$134.90
Typical High
$181.97

Where North Dakota 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.

North Dakota· 3rd of 51

$145

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.