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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

Indiana 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 $39$1410%20%10th90th$81Professionalmedian $40 · 10th–90th $32$600%20%40%10th90th$40$0.1$0.5$2.0$10.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$38.90
Median
$104.71
Typical High
$354.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$38.90
Typical High
$60.26
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$81.28
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$39.81
Typical High
$70.79
CareSource
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$85.11
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$53.70
Typical High
$104.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$69.18
United
Setting
Facility
Modifier
Global
Typical Low
$25.12
Median
$43.65
Typical High
$81.28
United
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$38.02
Typical High
$56.23