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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

Illinois rates for HCPCS L3650

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

Rates data updated July 2026.

Facilitymedian $81 · 10th–90th $41$4070%20%10th90th$81Professionalmedian $45 · 10th–90th $35$950%20%10th90th$45$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
$40.74
Median
$40.74
Typical High
$81.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$41.69
Typical High
$81.28
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$67.61
Typical High
$69.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$154.88
Typical High
$549.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$61.66
Typical High
$61.66
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$46.77
Typical High
$69.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$79.43
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$93.33
Typical High
$125.89
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Molina
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$36.31
United
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$64.57
Typical High
$81.28
United
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$47.86
Typical High
$114.82