Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Sio flex pelvic/sacr pre ots
Boulder, CO
See all hospitals reporting HCPCS L0621 →Price type
Boulder Community Health’s median price of $53 is 33% below the median hospital's median price ($79), higher than 12% of the 1,124 hospitals reporting HCPCS L0621. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 20 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna medicare advantage professional · fee schedule · both | $27 | $27 | — | — | — | $27 – $27 |
| 2 | UnitedHealthcare commercial professional · fee schedule · both | $30 | $30 | — | — | — | $30 – $30 |
| 3 | Aetna commercial professional · fee schedule · both | $39 | $39 | $12 | 31% | — | $27 – $51 |
| 4 | Healthpartners managed medicaid professional · fee schedule · both | $42 | $42 | — | — | — | $42 – $42 |
| 5 | Aetna medicare advantage facility · case rate · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 6 | Anthem medicare advantage facility · case rate · outpatient | $50 | $50 | — | — | — | $50 – $50 |
| 7 | Humana medicare advantage professional · fee schedule · both | $50 | $50 | — | — | — | $50 – $50 |
| 8 | Humana medicare advantage facility · case rate · outpatient | $51 | $51 | — | — | — | $51 – $51 |
| 9 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $51 | $51 | — | — | — | $51 – $51 |
| 10 | Kaiser medicare advantage facility · case rate · outpatient | $51 | $51 | $0 | 1% | — | $51 – $52 |
| 11 | Devoted medicare advantage facility · case rate · outpatient | $52 | $52 | — | — | — | $52 – $52 |
| 12 | Anthem commercial professional · fee schedule · both | $53 | $53 | — | — | — | $53 – $53 |
| 13 | Anthem managed care professional · fee schedule · both | $53 | $53 | — | — | — | $53 – $53 |
| 14 | Kaiser medicare advantage professional · fee schedule · both | $54 | $54 | — | — | — | $54 – $54 |
| 15 | Kaiser commercial professional · fee schedule · both | $64 | $64 | — | — | — | $64 – $64 |
| 16 | UnitedHealthcare medicare advantage professional · fee schedule · both | $67 | $67 | $16 | 25% | — | $50 – $83 |
| 17 | MultiPlan commercial professional · fee schedule · both | $77 | $77 | — | — | — | $77 – $77 |
| 18 | Phcs commercial professional · fee schedule · both | $77 | $77 | — | — | — | $77 – $77 |
| 19 | Kaiser commercial facility · case rate · outpatient | $110 | $110 | $13 | 12% | — | $96 – $123 |
| 20 | Kaiser managed care facility · case rate · outpatient | $122 | $122 | — | — | — | $122 – $122 |
Last updated: Sep 16, 2026
See Flexible pelvic and sacral support brace, prefabricated pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.