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Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

Nebraska rates for HCPCS L3650

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

Rates data updated July 2026.

Facilitymedian $79 · 10th–90th $32$2190%20%10th90th$79Professionalmedian $33 · 10th–90th $30$810%20%40%10th90th$33$20.0$50.0$100.0$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
$28.18
Median
$48.98
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$33.11
Typical High
$64.57
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$97.72
BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$75.86
Typical High
$75.86
Cigna
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$69.18
Typical High
$87.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$91.20
Typical High
$162.18
Medica
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$85.11
Typical High
$354.81
Medica
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$38.90
Typical High
$77.62
Midlands
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$208.93
Midlands
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Midlands
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$194.98
Typical High
$208.93
United
Setting
Facility
Modifier
Global
Typical Low
$29.51
Median
$63.10
Typical High
$79.43
United
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$38.02
Typical High
$64.57