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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

Michigan rates for HCPCS L3650

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

Rates data updated July 2026.

Facilitymedian $65 · 10th–90th $45$2630%20%10th90th$65Professionalmedian $47 · 10th–90th $36$1100%20%10th90th$47$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
$44.67
Median
$50.12
Typical High
$72.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$43.65
Typical High
$117.49
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$239.88
Typical High
$457.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$81.28
CareSource
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$42.66
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
$46.77
Typical High
$81.28
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$141.25
Typical High
$165.96
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$61.66
Typical High
$97.72
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$66.07
Typical High
$81.28
United
Setting
Facility
Modifier
Global
Typical Low
$21.88
Median
$64.57
Typical High
$89.13
United
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$37.15
Typical High
$63.10