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

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

Rates data updated October 2026.

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

$61.66

Typical negotiated rate. In Oregon, October 2026.

Insurers have agreed to pay about $61.66 for this service. The price depends on where it is billed: about $61.66 from a physician practice, and about $87.10 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$61.66$38.02 to $95.50
FacilityA hospital or hospital-owned outpatient department$87.10$58.88 to $166

How much rates vary

Facilitymedian $87 · 10th to 90th $52 to $174Professionalmedian $62 · 10th to 90th $38 to $182
$50$100$200facility $87professional $62

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$61.66
Typical High
$72.44
Cigna
Setting
Facility
Modifier
None
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$38.02
Typical High
$38.02
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$45.71
Median
$131.83
Typical High
$169.82
Moda Health
Setting
Facility
Modifier
None
Typical Low
$28.84
Median
$61.66
Typical High
$89.13
Moda Health
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$60.26
Typical High
$66.07
Pacific Source
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$87.10
Typical High
$169.82
Providence
Setting
Facility
Modifier
None
Typical Low
$37.15
Median
$52.48
Typical High
$72.44
Providence
Setting
Professional
Modifier
None
Typical Low
$38.02
Median
$57.54
Typical High
$93.33
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$58.88
Median
$295.12
Typical High
$346.74
Regence BlueShield
Setting
Professional
Modifier
None
Typical Low
$66.07
Median
$181.97
Typical High
$190.55
United
Setting
Facility
Modifier
None
Typical Low
$257.04
Median
$257.04
Typical High
$338.84
United
Setting
Professional
Modifier
None
Typical Low
$35.48
Median
$95.50
Typical High
$158.49

Where Oregon 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.

Oregon· 47th of 51

$61.66

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.