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South Carolina 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 $93 · 10th–90th $71–$1950%20%10th90th$93Professionalmedian $79 · 10th–90th $52–$1480%20%10th90th$79$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
$77.62 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $77.62 / $144.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $190.55 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $151.36
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $102.33 / $208.93
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $72.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $70.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $117.49 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $107.15 / $158.49