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Montana rates for HCPCS L3650

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

Facilitymedian $65 · 10th–90th $47–$1910%20%40%10th90th$65Professionalmedian $47 · 10th–90th $32–$1860%10%20%10th90th$47$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $43.65 / $186.21
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $69.18 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $69.18 / $69.18
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $125.89
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $125.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $60.26 / $89.13
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $69.18 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $34.67 / $40.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $32.36 / $50.12