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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

California rates for HCPCS L3650

Shoulder orthosis (SO), figure of eight design abduction restrainer, prefabricated, off-the-shelf

Rates data updated July 2026.

Facilitymedian $38 · 10th–90th $30$1740%20%10th90th$38Professionalmedian $42 · 10th–90th $32$2450%20%10th90th$42$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$10.23
Median
$38.90
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$41.69
Typical High
$245.47
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$52.48
Typical High
$79.43
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$38.02
Typical High
$173.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$40.74
Typical High
$97.72
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$138.04
Typical High
$213.80
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$100.00
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$46.77
Typical High
$46.77
Cigna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$46.77
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$43.65
Typical High
$107.15
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$81.28
Typical High
$144.54
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$426.58
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$562.34
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$72.44
Typical High
$107.15
Providence
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$69.18
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$165.96
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$46.77
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$32.36
Typical High
$89.13
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$38.90
Typical High
$91.20