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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

Hawaii rates for HCPCS L3650

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

Rates data updated July 2026.

Facilitymedian $35 · 10th–90th $5$470%20%40%10th90th$35Professionalmedian $105 · 10th–90th $39$1100%50%10th90th$105$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$5.37
Typical High
$46.77
Aetna
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$38.90
Typical High
$41.69
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$69.18
Typical High
$83.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$97.72
Typical High
$128.82
HMSA
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$109.65
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$104.71
Typical High
$147.91
United
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$40.74
United
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$54.95
Typical High
$128.82