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New Hampshire rates for HCPCS L3650

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

Facilitymedian $83 · 10th–90th $46–$1000%10%20%10th90th$83Professionalmedian $52 · 10th–90th $34–$710%20%10th90th$52$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $44.67 / $61.66
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $89.13 / $100.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $40.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $69.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $46.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $33.88 / $43.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $47.86 / $70.79
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $102.33