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

Nevada 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?

$56.23

Typical negotiated rate. In Nevada, October 2026.

Insurers have agreed to pay about $56.23 for this service. The price depends on where it is billed: about $54.95 from a physician practice, and about $60.26 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$54.95$38.02 to $95.50
FacilityA hospital or hospital-owned outpatient department$60.26$52.48 to $63.10

How much rates vary

Facilitymedian $60 · 10th to 90th $40 to $85Professionalmedian $55 · 10th to 90th $35 to $158
$50$100$200$500$1K$2Kfacility $60professional $55

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
Facility
Modifier
None
Typical Low
$34.67
Median
$34.67
Typical High
$39.81
Aetna
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$34.67
Typical High
$39.81
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$60.26
Median
$61.66
Typical High
$85.11
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Cigna
Setting
Facility
Modifier
None
Typical Low
$52.48
Median
$52.48
Typical High
$56.23
Cigna
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$38.02
Typical High
$52.48
Hometown Health
Setting
Professional
Modifier
None
Typical Low
$42.66
Median
$60.26
Typical High
$120.23
Select Health
Setting
Facility
Modifier
None
Typical Low
$60.26
Median
$60.26
Typical High
$4,265.80
Select Health
Setting
Professional
Modifier
None
Typical Low
$40.74
Median
$54.95
Typical High
$173.78
United
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$95.50
Typical High
$158.49
2 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Anthem BCBS
Setting
Professional
Modifier
RR · Rental
Typical Low
$38.90
Median
$39.81
Typical High
$39.81
Anthem BCBS
Setting
Professional
Modifier
UE · Used equipment
Typical Low
$29.51
Median
$29.51
Typical High
$29.51

Where Nevada 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.

Nevada· 49th of 51

$56.23

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.