go back

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

Utah 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 July 2026.

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

$72.44

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $72.44 for this service. The price depends on where it is billed: about $72.44 from a physician practice, and about $72.44 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$72.44$67.61 to $110
FacilityA hospital or hospital-owned outpatient department$72.44$72.44 to $87.10

How much rates vary

Facilitymedian $72 · 10th to 90th $72 to $89Professionalmedian $72 · 10th to 90th $35 to $257
$50$100$200facility $72professional $72

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$72.44
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$52.48
Cigna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$38.02
Typical High
$52.48
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$47.86
Typical High
$61.66
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$87.10
Typical High
$114.82
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$123.03
Select Health
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Select Health
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$89.13
Typical High
$173.78
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$89.13
Typical High
$107.15
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$117.49
United
Setting
Professional
Modifier
Global
Typical Low
$22.91
Median
$93.33
Typical High
$134.90

Where Utah sits

The same service costs 3.9 times more in Hawaii than in California. 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.

Utah· 44th of 51

$72.44

HI $204CA $52.48

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.