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

Wyoming 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?

$85.11

Typical negotiated rate. In Wyoming, October 2026.

Insurers have agreed to pay about $85.11 for this service. Most negotiated rates run $85.11 to $93.33.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $52 · 10th to 90th $52 to $112Professionalmedian $85 · 10th to 90th $38 to $112
$50$100facility $52professional $85

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Aetna
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$112.20
Typical High
$112.20
BCBS Wyoming
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
BCBS Wyoming
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
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
$52.48
United
Setting
Professional
Modifier
None
Typical Low
$33.88
Median
$95.50
Typical High
$109.65

Where Wyoming 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.

Wyoming· 33rd of 51

$85.11

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.