go back

Shoulder Orthosis (SO), Figure of Eight Abduction Restrainer

New Hampshire rates for HCPCS L3650

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

Rates data updated July 2026.

Facilitymedian $83 · 10th–90th $46$1020%20%10th90th$83Professionalmedian $50 · 10th–90th $32$710%20%10th90th$50$20.0$50.0$100.0$200.0$500.0

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
$45.71
Median
$45.71
Typical High
$831.76
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$45.71
Typical High
$54.95
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$89.13
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$40.74
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
$33.88
Typical High
$46.77
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$131.83
United
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$33.88
Typical High
$43.65
United
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$47.86
Typical High
$70.79
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$102.33