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Oklahoma 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 $76 · 10th–90th $71–$1820%20%40%10th90th$76Professionalmedian $74 · 10th–90th $52–$1260%20%10th90th$74$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
$74.13 / $74.13 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $72.44 / $97.72
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
$38.02 / $38.02 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $83.18 / $501.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $107.15 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $95.50 / $158.49