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Oregon 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 $59 · 10th–90th $59–$1660%50%90th$59Professionalmedian $72 · 10th–90th $50–$1480%20%10th90th$72$50.0$100.0$200.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $72.44 / $147.91
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 / $38.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $128.82 / $154.88
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $67.61 / $125.89
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $66.07 / $165.96
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $165.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $67.61 / $125.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $63.10 / $93.33
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $208.93 / $346.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $66.07 / $93.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $109.65 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $95.50 / $158.49