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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

Montana 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 $47$1910%20%40%10th90th$65Professionalmedian $55 · 10th–90th $32$1860%20%10th90th$55$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Global
Typical Low
$32.36
Median
$48.98
Typical High
$194.98
BCBS
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$69,183.10
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$69.18
Typical High
$69.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$69.18
Typical High
$69.18
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$125.89
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$64.57
Typical High
$125.89
Providence
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$60.26
Typical High
$89.13
Providence
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$69.18
Typical High
$79.43
United
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$34.67
Typical High
$40.74
United
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$32.36
Typical High
$50.12